A nurse is caring for a client who has end-stage kidney disease (ESKD) and reports having shortness of breath and swelling in his lower extremities. Upon assessment, the nurse notes the client has crackles in his lungs and an elevated blood pressure. The nurse should suspect which of the following based on the client's manifestations?
Hyponatremia
Hyperkalemia
Hypovolemia
Hypervolemia
The Correct Answer is D
A. Hyponatremia is characterized by low sodium levels in the blood and is not typically associated with crackles in the lungs or elevated blood pressure.
B. While hyperkalemia is a concern in end-stage kidney disease, it is not typically associated with crackles in the lungs or elevated blood pressure.
C. Hypovolemia, or low blood volume, is not consistent with the client's reported symptoms of swelling in the lower extremities and crackles in the lungs.
D. Hypervolemia, or fluid overload, is common in end-stage kidney disease and can manifest with symptoms such as shortness of breath, lower extremity edema, crackles in the lungs (due to pulmonary congestion), and elevated blood pressure.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","B","D"]
Explanation
A. Bone pain can occur in ESRD due to mineral and bone disorders associated with chronic kidney disease.
B. Slurred speech can be seen in ESRD patients with uremic encephalopathy.
C. Hypotension is less common in ESRD; hypertension is more typical due to fluid overload and retention.
D. Pruritus is a common symptom of ESRD, often due to accumulation of uremic toxins.
E. Bradypnea is not typically associated with ESRD.
Correct Answer is A
Explanation
A. Certain malignancies, particularly lung cancer, can produce ectopic antidiuretic hormone (ADH) or ADH-like substances, leading to SIADH. It's important to inquire about a history of lung cancer due to its association with SIADH.
B. Osteoarthritis is a degenerative joint disease and is not known to cause SIADH.
C. Dyspepsia refers to upper gastrointestinal discomfort and is not associated with SIADH.
D. Liver cirrhosis can lead to various complications, including hepatic encephalopathy and ascites, but it is not typically associated with SIADH.
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