You are planning the care for a client for a client with acute kidney injury (AKI). What should you prioritize in the client's plan of care? (Select all that apply)
Optimizing pain
Protecting from falls
Monitoring electrolyte levels
Assessing fluid balance
Promoting infection control
Correct Answer : C,D,E
A. Optimizing pain: While pain management is important in any patient care plan, acute kidney injury typically does not cause significant pain unless associated with another condition such as obstruction or infection. It is not a primary focus unless the patient reports discomfort requiring intervention.
B. Protecting from falls: Fall prevention is a general safety measure but is not a specific priority related to AKI management unless the patient has associated risks like altered mental status, weakness, or dialysis-related hypotension. It is not a primary priority in early AKI care planning.
C. Monitoring electrolyte levels: AKI commonly leads to imbalances in potassium, sodium, calcium, and phosphorus due to impaired renal clearance. Hyperkalemia in particular poses serious cardiac risks, making electrolyte monitoring a top priority to prevent complications such as arrhythmias.
D. Assessing fluid balance: AKI affects the kidneys’ ability to excrete or conserve fluid, resulting in potential fluid overload or dehydration. Accurate intake and output tracking, daily weights, and edema assessment are essential to guide treatment and prevent respiratory or cardiovascular compromise.
E. Promoting infection control: Infection is both a potential cause and a complication of AKI, especially in hospitalized or catheterized patients. Maintaining strict aseptic technique, monitoring for signs of infection, and preventing sepsis are critical components of AKI management.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Proteus mirabilis: While Proteus mirabilis is a recognized cause of UTIs, especially in catheterized patients or those with structural abnormalities, it is not the most common pathogen overall.
B. Escherichia coli: E. coli is by far the most common pathogen responsible for urinary tract infections, accounting for approximately 80–90% of uncomplicated UTIs due to its ability to adhere to the uroepithelium with fimbriae.
C. Staphylococcus saprophyticus: This organism is a common cause of UTIs in sexually active young women, but overall it is much less prevalent than E. coli across all age groups and sexes.
D. Klebsiella pneumoniae: Although K. pneumoniae can cause UTIs, particularly in hospitalized or immunocompromised patients, it is not as frequently encountered as E. coli in community-acquired cases.
Correct Answer is C
Explanation
A. Glomerulonephritis: This is an immune-mediated condition involving inflammation of the glomeruli and typically presents with proteinuria, hematuria, hypertension, and edema rather than urinary frequency, burning, or foul-smelling urine. The presence of E. coli and leukocytes does not support this diagnosis.
B. Kidney calculi: Kidney stones may present with flank pain, hematuria, and sometimes nausea or vomiting, but are not usually associated with urinary frequency, burning, or bacterial growth on urine culture. Randi’s symptoms point more toward an infectious etiology rather than a structural obstruction.
C. Lower UTI: cystitis (bladder infection) and possibly lower ureters: The burning, itching, frequent urination, and foul smell are classic signs of cystitis. The absence of flank pain and only a slightly elevated temperature further supports a lower tract infection rather than an upper one.
D. Upper UTI (pyelonephritis): Pyelonephritis typically presents with fever over 101°F, chills, nausea, vomiting, and significant costovertebral angle (CVA) tenderness or back/flank pain. Since Randi denies back pain and has only a mild temperature elevation, an upper UTI is unlikely.
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