A nurse is assisting with the care of a client who has acute kidney injury.

Which of the following findings require immediate follow-up by the nurse. (Select all that apply.)

Activity level

Blood pressure

BUN

Blood glucose

Urinary output

Blood creatinine level

Answer and Explanation

Correct Answer : A,B,C,E,F

A. Activity level: The client is lethargic, which can indicate worsening uremia, electrolyte imbalance, or decreased renal perfusion. Changes in mental status require immediate assessment to prevent complications such as encephalopathy.

B. Blood pressure: The client’s blood pressure is elevated at 142/92 mm Hg. Hypertension is common in acute kidney injury and can further impair renal function or increase the risk of cardiovascular complications, requiring prompt monitoring and management.

C. BUN: The BUN is 40 mg/dL, which is significantly above the normal range. Elevated BUN indicates azotemia and accumulation of nitrogenous waste products, reflecting impaired kidney function and necessitating immediate follow-up.

D. Blood glucose: The glucose level is 98 mg/dL, which is within the expected reference range. It does not require immediate intervention in this context.

E. Urinary output: The client’s urinary output is 26 mL/hr, which is below the normal threshold of 30 mL/hr. Oliguria indicates declining renal function and requires prompt evaluation and intervention.

F. Blood creatinine level: The creatinine is 4 mg/dL, markedly above normal, reflecting significant kidney injury. Elevated creatinine correlates with impaired glomerular filtration and requires immediate follow-up to guide treatment.

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Correct Answer is D

Explanation

A. "This test will inform your provider if you have an infection.": Serum creatinine does not provide information about infections. Laboratory tests for infection typically include white blood cell counts or cultures, not renal function markers.

B. "This test will inform your provider if you have a thyroid disorder.": Thyroid function is assessed with tests such as TSH, T3, and T4 levels. Serum creatinine does not indicate thyroid activity or dysfunction.

C. "This test will inform your provider if you are anemic.": Anemia is evaluated through complete blood count (CBC), hemoglobin, and hematocrit levels. Serum creatinine is unrelated to red blood cell production or anemia.

D. "This test will inform your provider how your kidneys are functioning.": Serum creatinine is a waste product of muscle metabolism filtered by the kidneys. Elevated levels indicate impaired renal function, making this test a key measure of kidney health and glomerular filtration efficiency.

A. Instruct the client to remain NPO 8 hr before the procedure. B. Review the coagulation studies before the procedure. C. Inform the client that the biopsy is performed while lying supine during the procedure. D. Administer a cleansing enema before the procedure.

Correct Answer is B

Explanation

A. Instruct the client to remain NPO 8 hr before the procedure: Kidney biopsies are typically performed under local anesthesia with sedation, not general anesthesia, so strict NPO status is usually unnecessary unless sedation is planned. Routine NPO for 8 hours is not a standard requirement for all clients.

B. Review the coagulation studies before the procedure: Kidney biopsy involves inserting a needle into highly vascular renal tissue, which carries a significant risk of bleeding. Reviewing coagulation studies (e.g., PT, INR, platelet count) ensures that the client’s blood clotting ability is adequate and minimizes the risk of post-procedure hemorrhage, making this a priority action.

C. Inform the client that the biopsy is performed while lying supine during the procedure: Kidney biopsies are usually performed with the client lying prone, often with a pillow under the abdomen to better expose the kidney.

D. Administer a cleansing enema before the procedure: A cleansing enema is not required for a kidney biopsy because the procedure does not involve the gastrointestinal tract. Administering one is unnecessary and does not affect the safety or success of the biopsy.

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A nurse is assisting with the care of a client who has acute kidney injury. Which of the following findings require immediate follow-up by the nurse. (Select all that apply.)

Nursing Test Bank

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Correct Answer is D

Explanation

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Correct Answer is B

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A nurse is assisting with the care of a client who has acute kidney injury.

Which of the following findings require immediate follow-up by the nurse. (Select all that apply.)