The nurse is reviewing laboratory test results for the client with liver disease and notes that the client's albumin level is low. Which nursing assessment indicates low albumin levels?

Evaluate for asterixis

Palpate for peripheral edema

Evaluate for decreased level of consciousness

Inspect for petechiae

Answer and Explanation

The Correct Answer is B

Choice A reason: Asterixis, also known as “liver flap,” is a type of tremor characterized by rapid, nonrhythmic extensions and flexions in the wrist and fingers. It is associated with hepatic encephalopathy, a condition that can occur with severe liver disease, but it is not a direct indicator of low albumin levels.

Choice B reason: Peripheral edema is a common clinical finding in patients with hypoalbuminemia, which is a low level of albumin in the blood. When albumin levels are low, fluid from the bloodstream can leak into body tissues, causing swelling, especially in the lower limbs. When assessing a client with liver disease and low albumin levels, palpating for peripheral edema would be the most relevant nursing assessment, as it directly correlates with the effects of hypoalbuminemia on fluid balance in the body. Albumin is a protein made by the liver that helps keep fluid in your blood vessels and plays a role in transporting substances throughout your body. Low levels of albumin can lead to fluid leaking out of blood vessels into tissues, causing swelling or edema.

Choice C reason: Decreased level of consciousness can be a sign of various conditions, including hepatic encephalopathy or other complications of liver disease, but it is not specifically indicative of low albumin levels.

Choice D reason: Petechiae are small red or purple spots caused by bleeding into the skin and may be associated with various conditions, including liver disease, but they are not a specific sign of low albumin levels.

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Correct Answer is ["24"]

Explanation

- Step 1: Identify the prescribed dose in units per hour. The client is scheduled to receive 1,200 units/hr of heparin.

- Step 2: Identify the concentration of the available solution. The available solution contains 25,000 units of heparin in 500 mL D5W.

- Step 3: Calculate the volume of solution needed to deliver the required dose. We can set up a proportion to solve for this:

- 25,000 units is to 500 mL as 1,200 units is to X mL.

- In other words, 25,000 units : 500 mL = 1,200 units : X mL.

- Step 4: Solve for X using cross-multiplication and division:

- Cross-multiplication gives us: 25,000 units × X mL = 1,200 units × 500 mL.

- Simplifying this gives us: 25,000X = 600,000.

- Dividing both sides by 25,000 gives us: X = 600,000 ÷ 25,000.

- Calculating the division gives us: X = 24.

Set the IV pump to deliver 24 mL/hr to administer the required dose of 1,200 units/hr.

A. pH 7.25, HCO3- 19 mEq/L, PaCO2 30 mm Hg B. pH 7.50, HCO3- 20 mEq/L, PaCO2 32 mm Hg C. pH 7.55, HCO3- 30 mEq/L, PaCO2 31 mm Hg D. pH 7.30, HCO3- 26 mEq/L, PaCO2 50 mm Hg

Correct Answer is A

Explanation

Choice A reason:

This set of values indicates metabolic acidosis, which is common in chronic kidney disease due to the accumulation of acids in the body as the kidneys fail to eliminate them effectively³.

Choice B reason:

A pH of 7.50 is considered alkalotic, and while HCO3- and PaCO2 are within normal ranges, this set of values does not typically represent chronic kidney disease.

Choice C reason:

A pH of 7.55 is also alkalotic, and an HCO3- of 30 mEq/L indicates metabolic alkalosis, which is not characteristic of chronic kidney disease.

Choice D reason:

While a pH of 7.30 is on the lower end of the normal range, an HCO3- of 26 mEq/L is within the normal range, and a PaCO2 of 50 mm Hg indicates respiratory acidosis, not typically seen in chronic kidney disease without concurrent respiratory issues.

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The nurse is reviewing laboratory test results for the client with liver disease and notes that the client's albumin level is low. Which nursing assessment indicates low albumin levels?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Correct Answer is ["24"]

Explanation

A nurse is reviewing the arterial blood gas (ABG) values of a client who has chronic kidney disease. Which of the following sets of values should the nurse expect?

Correct Answer is A

Explanation

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