A nurse is admitting a client to the emergency department after a gunshot wound to the abdomen. Which of the following actions should the nurse take to help prevent the onset of acute kidney failure?

Insert a urinary catheter.

Prepare the client for an intravenous pyelogram.

Administer IV fluids to the client.

Initiate beta blocker therapy.

Answer and Explanation

The Correct Answer is C

A. Insert a urinary catheter: While a urinary catheter may be necessary for monitoring urine output, it does not directly prevent acute kidney failure. Maintaining adequate perfusion and hydration is the primary concern in preventing kidney injury.

B. Prepare the client for an intravenous pyelogram: An intravenous pyelogram (IVP) involves contrast dye, which can be nephrotoxic and potentially worsen kidney function. It is not appropriate in a client at risk for acute kidney injury.

C. Administer IV fluids to the client: Fluid resuscitation helps maintain adequate renal perfusion and prevents hypovolemia-induced acute kidney failure. Clients with significant blood loss are at high risk for prerenal kidney injury due to decreased perfusion.

D. Initiate beta blocker therapy: Beta blockers are used for cardiovascular conditions but do not prevent acute kidney failure. In this situation, maintaining blood volume and renal perfusion is the priority.

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Free Nursing Study Resources

Correct Answer is C

Explanation

A. Increased body hair: Adrenal insufficiency leads to decreased androgen production, which may cause hair thinning rather than increased body hair. Hypertrichosis (excessive hair growth) is not a typical finding in adrenal insufficiency.

B. Decreased blood urea nitrogen level: Adrenal insufficiency is often associated with dehydration due to aldosterone deficiency, leading to reduced sodium retention and increased fluid loss. This can result in elevated blood urea nitrogen (BUN) levels rather than a decrease.

C. Hyperpigmentation of the skin: Increased melanocyte-stimulating hormone (MSH) activity, triggered by elevated adrenocorticotropic hormone (ACTH) levels, causes darkening of the skin, especially in sun-exposed areas, skin folds, and mucous membranes. This is a hallmark feature of primary adrenal insufficiency (Addison’s disease).

D. Hypocalcemia: Adrenal insufficiency is more commonly associated with hypercalcemia rather than hypocalcemia. Decreased cortisol levels can lead to reduced renal calcium excretion, contributing to elevated serum calcium levels.

A. Fluid overload B. Metabolic acidosis C. Hyponatremia D. Constipation

Correct Answer is C

Explanation

A. Fluid overload: While NG tubes can be used for enteral feeding, they are often associated with fluid losses from suctioning or drainage rather than overload. Clients with NG tubes are more prone to dehydration and electrolyte imbalances.

B. Metabolic acidosis: NG tube suctioning primarily removes gastric contents, which are rich in hydrochloric acid. This can lead to metabolic alkalosis rather than acidosis due to excessive loss of acidic gastric secretions.

C. Hyponatremia: Prolonged NG tube suctioning or drainage can lead to the loss of sodium-rich gastric secretions, resulting in hyponatremia. Monitoring electrolyte levels and replacing lost fluids appropriately is essential to prevent imbalances.

D. Constipation: NG tubes are more commonly associated with diarrhea due to enteral feeding formulas rather than constipation. However, reduced oral intake and immobility could contribute to constipation in some cases.

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A nurse is admitting a client to the emergency department after a gunshot wound to the abdomen. Which of the following actions should the nurse take to help prevent the onset of acute kidney failure?

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