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 D

Explanation

A. Hyperkalemia and hypernatremia are generally not associated with the diuretic phase of AKI. In the diuretic phase, the primary issue is excessive loss of electrolytes and fluid, rather than their accumulation.
B. Hypokalemia can occur during the diuretic phase because diuretics increase the excretion of potassium along with water. Hypernatremia is not typical of the diuretic phase. Instead, sodium levels might decrease or remain normal due to the loss of fluid and electrolytes.
C. Hyperkalemia is unlikely during the diuretic phase as diuretics often lead to increased potassium loss. Hyponatremia is a more likely outcome during the diuretic phase due to the loss of sodium and fluid through increased urine output.

D. During the diuretic phase of AKI, there is significant loss of electrolytes, including potassium and sodium. Diuretics increase urine output, leading to the loss of potassium and sodium, which can occur as a result of excessive fluid and electrolyte loss.

A. Insulin and sodium bicarbonate B. Calcium gluconate C. atiromer (Veltassa) D. Lisinopril

Correct Answer is C

Explanation

A. It helps to temporarily lower serum potassium levels by driving potassium into the cells. This effect is usually short-lived and is often used in emergency situations to quickly manage hyperkalemia.
B. Calcium Gluconate is used to stabilize the cardiac membrane in the setting of hyperkalemia, especially if there are ECG changes or symptoms of hyperkalemia. It does not lower the serum potassium level but helps protect the heart from the potential arrhythmias caused by elevated potassium levels.
C. Patiromer (Veltassa) is a potassium binder that helps to remove excess potassium from the body through the gastrointestinal tract. It binds potassium in the gut and facilitates its excretion in the stool.
D. Lisinopril is an ACE inhibitor used to treat hypertension and heart failure. It can actually increase potassium levels by decreasing the excretion of potassium through the kidneys.

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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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Naxlex Comprehensive Predictor Exams

During the diuretic phase of acute kidney injury, the nurse understands that the client is at risk for which of the following electrolyte imbalances?

Correct Answer is D

Explanation

A client with chronic kidney disease (CKD) has a serum potassium level of 6.5 mEq/L. Which of the following medications removes excess potassium from the body?

Correct Answer is C

Explanation

A nurse is teaching a client who has chronic kidney disease about limiting foods that are high in potassium. Which of the following are high-potassium foods which the client should avoid? (Select all that apply.)

A client with acute kidney injury (AKI) has a serum potassium level of 6.5 mEq/L. The nurse recognizes that administering IV calcium gluconate to this client will result in which of the following effects?

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