A client in acute renal failure has been admitted into the Med Surgical ICU due to hypovolemic shock. The client's family asks the nurse why the client has developed acute renal failure. The nurse's best response is?
This occurred because there was an obstruction of urine flow from the kidneys
This occurs because there was a decrease in blood flow to the kidneys
This occurred because there was structural damage to the kidneys resulting in acute tubular necrosis
This occurred because a blood cat formed in the kidneys
The Correct Answer is B
A. Obstruction of urine flow can lead to prerenal or postrenal acute kidney injury, but hypovolemic shock is a cause of decreased blood flow to the kidneys, not obstruction.
B. Hypovolemic shock leads to decreased blood flow to the kidneys, which can cause acute renal failure. This is the most appropriate cause of acute renal failure in the context of hypovolemic shock.
C. Acute tubular necrosis is a result of prolonged ischemia or direct kidney injury and may follow decreased blood flow, but the primary cause in this case is hypovolemic shock.
D. A blood clot in the kidneys may cause acute renal failure but is not the typical cause in hypovolemic shock.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Hyponatremia and hyperkalemia: In the oliguric phase, the kidneys retain potassium due to decreased excretion, leading to hyperkalemia. Hyponatremia occurs due to fluid retention and dilutional effects.
B. Hyperkalemia and hypophosphatemia: Hyperkalemia is expected, but hypophosphatemia is not typical; phosphate tends to accumulate due to reduced renal clearance.
C. Hypokalemia and hyponatremia: Hypokalemia is not expected; the kidneys fail to excrete potassium, causing hyperkalemia.
D. Hypernatremia and hypokalemia: Neither hypernatremia nor hypokalemia is consistent with the oliguric phase.
Correct Answer is ["C","D","E"]
Explanation
A. Initiate 0.33% sodium chloride IV bolus: This is inappropriate as it does not address hyperkalemia and may worsen fluid balance issues.
B. Administration of an ACE inhibitor: ACE inhibitors can increase potassium levels and are contraindicated in hyperkalemia.
C. Administration of sodium polystyrene sulfate (Kayexalate): This medication promotes potassium excretion through the gastrointestinal tract.
D. Place the client on a cardiac monitor: Hyperkalemia affects cardiac function, and continuous monitoring is necessary to detect arrhythmias.
E. Administration of calcium gluconate: Calcium gluconate helps stabilize the cardiac membrane, reducing the risk of arrhythmias from hyperkalemia.
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