A nurse evaluates a client with acute glomerulonephritis (GN). Which assessment finding would the nurse recognize as a positive response to the prescribed treatment?
The client's blood pressure is 152/88 mm Hg.
The client lost 11 lb (5 kg) in the past 10 days.
No blood is observed in the client's urine.
The client's urine specific gravity is 1.048.
The Correct Answer is C
Rationale:
A. A blood pressure of 152/88 mm Hg indicates persistent hypertension, which is a common complication of glomerulonephritis. This finding suggests that the condition has not fully resolved and that further management is needed to control blood pressure.
B. Losing 11 lb (5 kg) in 10 days could indicate fluid loss from diuretic therapy, but such a rapid weight reduction may also point to excessive fluid removal or malnutrition. While it might show some improvement in fluid overload, it is not the best indicator of recovery from glomerulonephritis.
C. Absence of blood in the urine is a positive sign of improvement. Hematuria is a hallmark symptom of glomerulonephritis caused by inflammation and damage to the glomeruli. Resolution of hematuria indicates decreased inflammation and improved kidney function, showing that the treatment is effective.
D. A urine specific gravity of 1.048 is abnormally high, suggesting concentrated urine due to fluid deficit or impaired kidney function. This finding does not reflect improvement and may indicate ongoing renal compromise.
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Related Questions
Correct Answer is D
Explanation
Rationale:
A. A kidney biopsy helps confirm the diagnosis of nephrotic syndrome and identify the underlying cause of glomerular damage.
B. Periorbital (facial) edema is a common manifestation of nephrotic syndrome due to severe protein loss and resulting hypoalbuminemia, which causes fluid to shift into the interstitial spaces.
C. Proteinuria is a hallmark feature of nephrotic syndrome caused by increased glomerular permeability, leading to significant loss of protein, especially albumin, in the urine.
D. This statement indicates a need for further teaching. Clients with nephrotic syndrome should restrict sodium intake to help manage edema and prevent further fluid retention. Increasing sodium can worsen swelling and hypertension.
Correct Answer is A
Explanation
Rationale:
A. A serum creatinine level of 6 mg/dL is significantly elevated above the normal range (0.6–1.3 mg/dL) and is a key indicator of acute kidney injury (AKI). Creatinine rises when the kidneys cannot effectively filter waste products from the blood, reflecting a reduction in glomerular filtration rate (GFR). This finding strongly suggests impaired renal function.
B. A serum potassium of 4.5 mEq/L is within the normal range (3.5–5.0 mEq/L) and does not indicate AKI. In kidney injury, potassium is typically elevated due to reduced excretion.
C. A hemoglobin level of 16 g/dL is within the normal range (13–17 g/dL for males, 12–15 g/dL for females) and is unrelated to AKI.
D. A BUN level of 15 mg/dL is normal (reference range 7–20 mg/dL) and does not suggest kidney dysfunction.
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