What nursing assessment finding would suggest inadequate renal perfusion in a patient being stabilized after an acute coronary syndrome (myocardial infarction)?

Low urine osmolarity and creatinine clearance.

Decreasing serum blood urea nitrogen (BUN) level.

Urine output of less than 30 mL/hr.

Urine specific gravity of less than 1.010.

Answer and Explanation

The Correct Answer is C

Choice A rationale
Low urine osmolarity and creatinine clearance are not the primary indicators of inadequate renal perfusion in a patient being stabilized after an acute coronary syndrome. These measures reflect the concentration of the urine and the kidney’s ability to filter waste from the blood, respectively. While they can be affected by renal perfusion, they are not the most direct or reliable indicators.
Choice B rationale
A decreasing serum blood urea nitrogen (BUN) level is not typically associated with inadequate renal perfusion. In fact, a high BUN level may indicate that the kidneys aren’t working properly. However, BUN levels can be influenced by many factors, including protein intake and liver function, so they are not the most reliable indicator of renal perfusion.
Choice C rationale
A urine output of less than 30 mL/hr is a common sign of inadequate renal perfusion. The kidneys need adequate blood flow to filter waste products from the blood and produce urine. If renal perfusion is inadequate, urine output can decrease.
Choice D rationale
A urine-specific gravity of less than 1.010 is not typically associated with inadequate renal perfusion. Specific gravity is a measure of the concentration of solutes in the urine. It can be influenced by hydration status and certain kidney disorders, but it is not a direct measure of renal perfusion.

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Correct Answer is A

Explanation

Choice A rationale
Standing frequently can help promote blood flow in the legs, which can be beneficial for a patient with arterial insufficiency. This is because standing engages the muscles in the legs, which helps push blood back up towards the heart.
Choice B rationale
Walking without shoes is not typically recommended for patients with arterial insufficiency. This is because these patients often have reduced sensation in their feet and may not notice if they step on something sharp or if a wound develops.
Choice C rationale
Vigorous massage of the legs is not usually recommended for patients with arterial insufficiency. While gentle massage can help promote blood flow, vigorous massage could potentially damage the arteries further.
Choice D rationale
Allowing the legs to dangle dependently often is not typically recommended for patients with arterial insufficiency. This position can actually increase swelling and discomfort in the legs.

A. A patient who experienced dizziness after the first dose of captopril. B. A patient exhibiting new-onset confusion, restlessness, and cool, clammy skin. C. A patient on oxygen therapy with bilateral crackles at the lung bases. D. A patient on IV nesiritide (Natrecor) with a blood pressure reading of 100/62.

Correct Answer is B

Explanation

Choice A rationale
While dizziness after the first dose of captopril can be concerning, it is not uncommon as the body adjusts to the medication. It is important to monitor this patient, but they are not the highest priority.
Choice B rationale
A patient exhibiting new-onset confusion, restlessness, and cool, clammy skin should be prioritized for assessment. These symptoms could indicate a serious condition such as shock or decreased cardiac output. This patient may be experiencing a rapid decline in condition and should be assessed immediately.
Choice C rationale
While a patient on oxygen therapy with bilateral crackles at the lung bases may have worsening heart failure, they are not the highest priority if they are stable. Crackles at the lung bases are a common finding in heart failure and indicate fluid accumulation in the lungs.
Choice D rationale
A patient on IV nesiritide (Natrecor) with a blood pressure reading of 100/62 is not the highest priority. While this blood pressure is on the lower side, it is not critically low.
Nesiritide can cause hypotension, so this patient should be monitored, but they are not the highest priority if they are stable.

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What nursing assessment finding would suggest inadequate renal perfusion in a patient being stabilized after an acute coronary syndrome (myocardial infarction)?

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Naxlex Comprehensive Predictor Exams

What is the most appropriate advice for a patient suffering from arterial insufficiency?

Correct Answer is A

Explanation

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Correct Answer is B

Explanation

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