A client is admitted to the emergency room with renal calculi. Upon assessment, which of the following findings should the nurse expect?
Bradycardia
Bradypnea
Severe pain
Nocturia
The Correct Answer is C
Choice A reason: Bradycardia, which is a slower than normal heart rate, is not a common finding associated with renal calculi. Renal calculi, or kidney stones, typically cause symptoms related to the urinary system rather than directly affecting the heart rate.
Choice B reason: Bradypnea, or abnormally slow breathing, is also not a typical symptom of renal calculi. Patients with kidney stones may experience changes in urination patterns, such as frequency or urgency, but not typically changes in respiratory rate.
Choice C reason: Severe pain is indeed the most common symptom associated with renal calculi. This pain, known as renal colic, is often sudden in onset, very severe, and may radiate from the back down to the lower abdomen or groin. The pain is caused by the stone moving into the ureter and causing a blockage, which leads to increased pressure and stretching of the kidney or ureter. Renal calculi can cause a range of symptoms, with severe pain being the most prominent and often the first symptom that leads individuals to seek medical care. The pain is typically very intense and can be accompanied by other symptoms such as nausea, vomiting, and hematuria (blood in the urine).
Choice D reason: Nocturia, or frequent urination at night, can be a symptom of renal calculi, especially if the stones affect the bladder or cause urinary tract infections. However, the most characteristic symptom of renal calculi is severe pain, not necessarily nocturia.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason: Sodium level is not a direct measure of fluid volume. While sodium balance can influence fluid status, the serum sodium level can be affected by various factors and does not reliably indicate fluid volume increase on its own.
Choice B reason: Intake and output records are important for managing fluid balance, especially in a hospital setting. However, they can be influenced by many factors, such as incomplete recording or insensible losses, and do not provide a direct measure of fluid retention.
Choice C reason: Daily weight is considered the most reliable measure of fluid retention. Weight changes can reflect fluid balance accurately because 1 liter of fluid is roughly equivalent to 1 kilogram of body weight. In clients with chronic kidney disease, daily weight monitoring can help detect fluid volume increases or decreases promptly. For a client with chronic kidney disease, daily weight monitoring is a key assessment tool for detecting fluid volume changes. It provides a quantifiable and objective measure that can guide interventions to manage fluid balance effectively.
Choice D reason: Tissue turgor, which refers to the skin’s elasticity, is not a reliable measure of fluid volume. It can be influenced by age, edema, and other factors, and changes in turgor may not accurately reflect fluid status in the body.
Correct Answer is C
Explanation
Choice A: RBC count The red blood cell (RBC) count is not typically decreased by hemodialysis. Hemodialysis does not remove cells from the blood. However, patients with chronic kidney disease often have anemia, which is a low RBC count, due to a decrease in the production of erythropoietin by the kidneys. Erythropoietin is a hormone that stimulates the bone marrow to produce RBCs. Anemia in these patients is treated with erythropoiesis-stimulating agents, not dialysis.
Choice B: Protein Protein levels are not directly affected by hemodialysis. However, patients on hemodialysis may have lower protein levels due to dietary restrictions or protein loss during the treatment. It is important for patients to manage their protein intake to prevent malnutrition and maintain overall health.
Choice C: Potassium Potassium levels are expected to decrease following hemodialysis. Potassium is an electrolyte that is normally filtered out by the kidneys. In patients with kidney failure, potassium levels can build up in the blood and cause serious heart problems. Hemodialysis removes excess potassium from the blood, which helps to prevent complications such as cardiac arrhythmia. The normal range for serum potassium is 3.5 to 5.0 mmol/L. After a hemodialysis treatment, a nurse should expect to find a decrease in potassium levels in the laboratory data of a client. This is because hemodialysis effectively removes excess potassium, which can accumulate in the blood due to reduced kidney function. Maintaining proper potassium levels is crucial for preventing heart complications in patients with kidney failure.
Choice D: Calcium Calcium levels are not typically decreased by hemodialysis. In fact, calcium levels can be affected by the dialysate used during hemodialysis. Some dialysates contain calcium, and this can actually increase the patient’s blood calcium levels. Patients with kidney failure may also have secondary hyperparathyroidism, which affects calcium levels, and they may be treated with calcium supplements or vitamin D analogs to manage their calcium levels.
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