A client with hydronephrosis secondary to an untreated kidney stone is being monitored. Which complication is the nurse most concerned about?
Recurrent urinary frequency
Renal failure
Diabetic nephropathy
Orthostatic hypotension
The Correct Answer is B
Rationale:
A. Recurrent urinary frequency may occur as a symptom of urinary tract obstruction or irritation, but it is a relatively minor and common manifestation. While uncomfortable for the client, urinary frequency itself is not the most serious or life-threatening complication of hydronephrosis.
B. Renal failure is the primary concern in a client with hydronephrosis caused by an untreated kidney stone. Hydronephrosis occurs when urine flow is obstructed, leading to increased pressure within the renal pelvis and calyces. This pressure compresses renal tissue, impairs blood flow, and damages nephrons. If the obstruction persists, it can result in progressive kidney damage and potentially irreversible renal failure. The longer the obstruction remains untreated, the higher the risk of permanent loss of renal function, making renal failure the most serious and concerning complication.
C. Diabetic nephropathy is a form of chronic kidney disease caused by long-term diabetes mellitus. It is unrelated to hydronephrosis from urinary obstruction. While clients with diabetes may have an increased risk of kidney disease, diabetic nephropathy is not a direct complication of untreated kidney stones.
D. Orthostatic hypotension is a drop in blood pressure upon standing, often caused by dehydration, autonomic dysfunction, or certain medications. It is not a direct complication of hydronephrosis and is less clinically urgent than the risk of renal failure in this context.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Rationale:
A. Thrombocytosis refers to an elevated platelet count, which can increase the risk of clot formation. It is unrelated to white blood cells and does not indicate infection or inflammation.
B. Neutropenia is a decreased number of neutrophils, a type of white blood cell, which can increase susceptibility to infections. This term represents a deficiency rather than an increase in white blood cells.
C. Anemia refers to a reduced number of red blood cells or decreased hemoglobin, leading to impaired oxygen delivery. It is unrelated to white blood cell counts or immune response.
D. Leukocytosis is defined as an increase in the total number of white blood cells (leukocytes), often in response to infection, inflammation, stress, or certain hematologic disorders. This increase is part of the body’s immune response, helping to fight pathogens and promote healing.
Correct Answer is B
Explanation
Rationale:
A. Increased cardiac output leading to muscle fatigue is incorrect. Intermittent claudication is not caused by cardiac output. While the heart supplies blood to the muscles, the issue in claudication is localized arterial insufficiency, not systemic cardiac function.
B. Atherosclerosis leading to reduced blood flow to the muscles is correct. Intermittent claudication occurs when arterial blood flow to the leg muscles is insufficient during exercise. Atherosclerotic plaques narrow or occlude peripheral arteries, reducing oxygen delivery to the muscles during increased activity. This oxygen deficit results in pain, cramping, and fatigue, which typically resolves with rest when oxygen demand decreases. Claudication is a hallmark symptom of peripheral artery disease (PAD).
C. Decreased oxygen demand in the leg muscles is incorrect. The symptom arises because oxygen demand exceeds supply, not because demand decreases. The muscles are actively working during exercise, which increases oxygen requirements, revealing the underlying ischemia caused by arterial obstruction.
D. Increased venous pressure causing fluid accumulation in the legs is incorrect. Venous insufficiency can cause edema and heaviness, but it does not produce the characteristic exercise-induced pain of intermittent claudication. Claudication is primarily an arterial problem rather than a venous one.
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