A nurse is caring for a client in the nephrology unit.
In the context of diabetes impacting kidney health, which nursing actions are anticipated or contraindicated in managing potential complications?
Administer NSAIDs for pain relief
Encourage high-protein diet
Assess for signs of fluid overload
Monitor blood glucose levels regularly
The Correct Answer is {"A":{"answers":"B"},"B":{"answers":"B"},"C":{"answers":"A"},"D":{"answers":"A"}}
- Administering NSAIDs for pain relief is contraindicated because NSAIDs can further impair kidney function by reducing renal perfusion and promoting nephrotoxicity. In a client with elevated BUN and creatinine, these drugs can accelerate kidney injury and worsen fluid retention or hypertension.
- Encouraging a high-protein diet is contraindicated in this scenario. Excess protein intake increases the workload on the kidneys and can exacerbate azotemia in clients with chronic kidney disease, particularly when BUN and creatinine are already elevated.
- Assessing for signs of fluid overload is an anticipated nursing action. The client presents with edema, periorbital swelling, and decreased urine output, indicating fluid retention. Monitoring for increased edema, lung sounds, weight gain, and blood pressure helps prevent complications such as pulmonary edema or worsening hypertension.
- Monitoring blood glucose levels regularly is an anticipated nursing action because diabetes contributes to kidney damage and can complicate the management of chronic kidney disease. Maintaining optimal glucose control reduces further renal injury and helps prevent acute complications such as hyperglycemia-related fluid shifts.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. RBC: Chronic glomerulonephritis often leads to anemia because the damaged kidneys produce less erythropoietin, a hormone necessary for red blood cell production. A decrease in RBC count is therefore an expected finding in this condition.
B. Potassium: Potassium levels usually increase rather than decrease in chronic glomerulonephritis because of reduced kidney function and impaired excretion. Hyperkalemia is a common complication that requires close monitoring.
C. Phosphate: Phosphate levels tend to rise in chronic kidney disease since the kidneys cannot excrete phosphate efficiently. This leads to hyperphosphatemia, which contributes to bone mineral imbalances, not a decrease.
D. Creatinine: Creatinine levels increase in chronic glomerulonephritis because of impaired filtration and reduced clearance. Elevated serum creatinine is one of the key indicators of declining kidney function.
Correct Answer is A
Explanation
A. Cardiac rhythm: Calcium gluconate is administered in hyperkalemia primarily to stabilize cardiac membranes and prevent life-threatening dysrhythmias. Monitoring the cardiac rhythm allows the nurse to evaluate the immediate effectiveness of the medication in reducing the risk of arrhythmias caused by elevated potassium levels.
B. Neurologic status: While hyperkalemia can cause muscle weakness or paresthesia, calcium gluconate does not lower serum potassium levels and therefore has minimal direct impact on neurologic symptoms. Monitoring neurologic status is important but not the primary measure of effectiveness.
C. Urine volume: Calcium gluconate does not promote potassium excretion or diuresis. Monitoring urine output is essential for overall renal function assessment but does not reflect the immediate cardiac-protective effect of the drug.
D. Calcium level: Although calcium gluconate raises serum calcium temporarily, the dose given for hyperkalemia does not significantly alter laboratory calcium levels. The clinical focus is on cardiac membrane stabilization rather than correcting hypocalcemia.
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