A client is taking furosemide 40 mg/day for management of early chronic kidney disease (CKD). To assess the therapeutic effect of the medication, what action of the nurse is best?
Obtain daily weights of the client.
Assess for acid-base balance.
Assess the client's serum creatinine.
Auscultate heart sounds.
The Correct Answer is A
Choice A reason: Obtaining daily weights of the client is the best action to assess the therapeutic effect of furosemide in managing early chronic kidney disease. Daily weights provide valuable information about fluid balance and the effectiveness of the diuretic in reducing fluid retention. Consistent weight monitoring helps determine if the medication is achieving its goal of managing fluid overload, which is a common issue in CKD patients.
Choice B reason: Assessing acid-base balance is important in managing CKD, but it is not the primary action to assess the therapeutic effect of furosemide. While diuretics can influence electrolyte levels and acid-base balance, monitoring fluid status through daily weights is more directly related to evaluating the effectiveness of the medication.
Choice C reason: Assessing the client's serum creatinine is crucial for monitoring kidney function and progression of CKD. However, it is not the primary action to determine the therapeutic effect of furosemide. The focus of furosemide therapy is to manage fluid balance, and daily weights provide a more immediate and relevant assessment of this effect.
Choice D reason: Auscultating heart sounds is part of a comprehensive assessment of a CKD patient, but it is not the best action to evaluate the therapeutic effect of furosemide. Heart sounds can provide information about cardiac function and potential complications, but they do not directly measure the effectiveness of fluid management achieved by the diuretic.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["B","C","D","E"]
Explanation
Choice A reason: Age is a non-modifiable risk factor for coronary artery disease. While it is a significant risk factor, individuals cannot change their age. Modifiable risk factors are those that individuals can alter through lifestyle changes or medical interventions to reduce their risk of developing coronary artery disease.
Choice B reason: Hypertension, or high blood pressure, is a modifiable risk factor for coronary artery disease. By managing blood pressure through lifestyle changes, medications, and regular monitoring, individuals can reduce their risk of developing coronary artery disease. Effective management of hypertension includes reducing sodium intake, maintaining a healthy weight, exercising regularly, and taking prescribed medications.
Choice C reason: Obesity is a modifiable risk factor for coronary artery disease. Individuals can work towards achieving and maintaining a healthy weight through dietary changes, increased physical activity, and behavioral modifications. Losing weight can significantly lower the risk of coronary artery disease by improving blood pressure, cholesterol levels, and overall cardiovascular health.
Choice D reason: Smoking is a major modifiable risk factor for coronary artery disease. Quitting smoking can dramatically reduce the risk of developing coronary artery disease and other cardiovascular conditions. Smoking cessation programs, medications, and support groups can help individuals successfully quit smoking and improve their cardiovascular health.
Choice E reason: Stress is a modifiable risk factor for coronary artery disease. Chronic stress can contribute to the development of coronary artery disease by affecting blood pressure, cholesterol levels, and overall heart health. Managing stress through relaxation techniques, exercise, counseling, and mindfulness practices can help reduce the risk of coronary artery disease.
Correct Answer is B
Explanation
Choice A reason: A blood pressure of 158/90 mm Hg in a patient with chronic kidney disease (CKD) is elevated and requires management to prevent complications. However, it is not as immediately life-threatening as Kussmaul respirations, which indicate severe metabolic acidosis.
Choice B reason: The patient with Kussmaul respirations should be assessed first. Kussmaul respirations are deep, labored breathing patterns typically associated with severe metabolic acidosis, such as diabetic ketoacidosis (DKA) or severe kidney failure. This condition requires immediate intervention to correct the underlying acidosis and stabilize the patient's condition.
Choice C reason: Itching (pruritus) is a common symptom in CKD due to the accumulation of uremic toxins. While it can be very uncomfortable and requires treatment, it is not as urgent as Kussmaul respirations, which indicate a potentially life-threatening situation.
Choice D reason: Halitosis (bad breath) and stomatitis (inflammation of the mouth) can occur in CKD due to the buildup of uremic toxins and other factors. These symptoms need attention, but they do not indicate an immediate threat to the patient's life compared to Kussmaul respirations.
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