A nurse is assessing a client who has chronic kidney disease (CKD) for fluid volume overload prior to scheduled hemodialysis. Which of the following methods provides a reliable measurement of the amount of fluid the client has retained since the last dialysis treatment?

Comparing the client's current weight to the last post-dialysis weight.

Measuring the client's current creatinine and BUN levels.

Assessing the client's skin turgor and peripheral edema.

Auscultating the client's lung sounds for crackles.

Answer and Explanation

The Correct Answer is A

A.   This method is the most reliable for measuring fluid retention. Weight changes are a direct indicator of fluid balance because fluid retention or loss affects body weight. By comparing the client's current weight to their post-dialysis weight, you can determine the amount of fluid they have retained.

B.   Creatinine and blood urea nitrogen (BUN) levels are indicators of kidney function rather than fluid volume status. Elevated levels can indicate worsening kidney function but do not directly measure fluid retention or overload.
C.   While assessing skin turgor and peripheral edema can provide some clues about fluid overload, these signs are less precise and subjective compared to weight measurements. Skin turgor changes and edema can be influenced by various factors, including skin elasticity and other conditions, making them less reliable for accurately measuring fluid volume changes since the last dialysis.
D.   Crackles in lung sounds can indicate pulmonary congestion due to fluid overload, but this method is not as precise for quantifying the amount of fluid retained. Crackles suggest fluid accumulation in the lungs, which is a sign of more severe fluid overload but does not provide a specific measurement of fluid volume compared to changes in body weight.

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Correct Answer is C

Explanation

A. Gentamicin is an aminoglycoside antibiotic used to treat bacterial infections. It is not appropriate for managing CKD directly and is generally avoided in patients with kidney impairment due to its potential nephrotoxicity.
B. Potassium supplements are typically not recommended unless there is a documented deficiency in potassium. In stage 3a CKD, managing potassium levels is crucial, but supplements are not usually needed unless potassium levels are low.
C. Captopril is an angiotensin-converting enzyme (ACE) inhibitor. ACE inhibitors are beneficial for patients with CKD as they help lower blood pressure and provide renal protective effects. They can reduce proteinuria (protein in urine), which is common in CKD, and may slow the progression of kidney disease.
D. Metformin is an oral medication used to manage type 2 diabetes by improving insulin sensitivity and lowering blood glucose levels. Although it is important to monitor blood glucose in CKD patients, this
client’s fasting blood glucose is within normal range (83 mg/dL), so Metformin is not indicated unless there was evidence of diabetes or significant glucose dysregulation.

A. A prostate examination B. A blood glucose check C. Genetic testing D. Antistreptolysin-O titers

Correct Answer is D

Explanation

A. A prostate examination is typically performed for issues related to the prostate, such as benign prostatic hyperplasia or prostate cancer. It is not relevant to diagnosing or managing acute glomerulonephritis, which is related to kidney inflammation rather than prostate issues.
B. A blood glucose check is used to diagnose and manage diabetes. While diabetes can contribute to chronic kidney disease, it is not the primary test for diagnosing acute glomerulonephritis or identifying its most common cause.
C. Genetic testing is useful for diagnosing inherited conditions or genetic predispositions to diseases. However, acute glomerulonephritis is typically caused by an infection or an autoimmune reaction, and genetic testing is not the primary diagnostic tool for this condition.
D. Antistreptolysin-O (ASO) titers are tests used to detect antibodies produced in response to a streptococcal infection. Elevated ASO titers indicate a recent streptococcal infection, which is the most common cause of post-infectious acute glomerulonephritis.

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A nurse is assessing a client who has chronic kidney disease (CKD) for fluid volume overload prior to scheduled hemodialysis. Which of the following methods provides a reliable measurement of the amount of fluid the client has retained since the last dialysis treatment?

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Correct Answer is C

Explanation

A nurse is admitting a client who has been diagnosed with acute glomerulonephritis. Considering the most common cause of this condition, which test should the nurse anticipate will be performed?

Correct Answer is D

Explanation

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A nurse is assessing a client who has chronic kidney disease (CKD) for fluid volume overload prior to scheduled hemodialysis. Which of the following methods provides a reliable measurement of the amount of fluid the client has retained since the last dialysis treatment?

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