A client receives a 12-lead electrocardiogram (ECG) and asks the practical nurse (PN) what the test is measuring. Which information should the PN explain about this diagnostic test?

Choice A reason: Measuring intake and output while straining all urine is the priority action. This helps to monitor kidney function, assess fluid balance, and detect the passage of kidney stones. Straining urine can also catch any stones or fragments, which can be analyzed to determine their composition and guide further treatment.
Choice B reason: Reviewing foods that are high in oxalate is important for dietary management of kidney stones, but it is not the immediate priority. Dietary education is more relevant once the client's acute symptoms are managed and stabilized.
Choice C reason: Monitoring the client's serum calcium levels is important in the management of certain types of kidney stones, particularly those formed from calcium. However, this action is not as immediate a priority as measuring intake and output and straining urine to assess for stone passage.
Choice D reason: Encouraging the client to begin a weight loss program is beneficial for overall health and can reduce the risk of future kidney stones. However, it is not the immediate priority when treating an acute episode of kidney stones.

Choice A reason: Facial pallor, particularly around the lips, could indicate anemia or poor perfusion, but it is not the most urgent finding in this context. Polycythemia vera typically involves an overproduction of red blood cells, which can actually result in a ruddy complexion rather than pallor. While pallor should be monitored, it does not require immediate reporting compared to other potential complications of polycythemia vera.
Choice B reason: An increased heart rate over the last 4 hours could be a sign of various conditions, such as dehydration, fever, or cardiovascular stress. However, in the context of polycythemia vera, it is not as immediately concerning as symptoms that might indicate thrombotic complications, which are a common and serious risk for these patients. Tachycardia should be monitored, but it is not the most critical finding needing immediate attention.
Choice C reason: Dark brown stools could indicate the presence of digested blood, suggesting gastrointestinal bleeding. While this is an important finding that requires further investigation, it is not as immediately life-threatening as signs of deep vein thrombosis (DVT) in a client with polycythemia vera. Bleeding risks do exist with this condition, but the urgency of DVT symptoms demands prompt intervention to prevent further complications, such as a pulmonary embolism.
Choice D reason: Right lower leg redness and edema are classic signs of deep vein thrombosis (DVT). Clients with polycythemia vera are at increased risk for thrombotic events due to the hyperviscosity of their blood. Reporting this finding immediately is critical, as DVT can lead to serious complications, including pulmonary embolism, which can be life-threatening. Early detection and intervention are essential in managing thrombotic risks in polycythemia vera patients.