A nurse is caring for a client who has impaired renal function. For which of the following findings should the nurse notify the provider?

Urine output of 175 ml in the past 8 hrs

Urine output of 2,200 ml in the past 24 hr

Urine is cloudy after sitting in the urinal for 6 hr

First-voided urine in the morning has a strong odor

Answer and Explanation

The Correct Answer is A

A.   A urine output of 175 ml over 8 hours indicates oliguria, which can be concerning in a client with impaired renal function. It suggests decreased kidney function and inadequate elimination of waste products and fluids, necessitating prompt notification of the healthcare provider.
B.   This amount of urine output over 24 hours is within normal range and does not typically warrant immediate notification unless there are other concerning symptoms.
C.   Cloudy urine may indicate the presence of urinary tract infection or other issues, but it alone may not require immediate notification of the provider.
D.   While strong-smelling urine can be indicative of various conditions, it alone may not necessitate immediate provider notification unless accompanied by other concerning symptoms.

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Correct Answer is B

Explanation

A. This is incorrect because the pH is indicative of alkalosis, not acidosis, and the body has not compensated.
B. The arterial blood gas (ABG) values provided indicate a pH of 7.6, which is above the normal range (7.35-7.45), suggesting alkalosis. The PaCO2 is low at 31 mm Hg, indicating hyperventilation, which is a respiratory process. Since the HCO3 is normal at 25 mmol/L, it suggests that the metabolic system is not the cause of the alkalosis. The body has not had time to compensate for the high pH with renal adjustments to the bicarbonate level, which would be seen in a partially compensated state.
C. This is incorrect because the bicarbonate level is normal, suggesting the metabolic system is not the cause.
D. This is incorrect because the bicarbonate level is normal, suggesting the metabolic system is not the cause.

A. Urine output is less than 400 mL per 24 hr. B. BUN and creatinine levels decrease. C. Renal function is reestablished. D. The glomerular filtration rate (GFR) recovers

Correct Answer is A

Explanation

A. Oliguria, characterized by urine output less than 400 mL per 24 hours, is a hallmark of the oliguric phase of acute kidney injury.
B. BUN and creatinine levels typically increase during the oliguric phase due to decreased kidney function.
C. Renal function is not reestablished during the oliguric phase; this phase represents reduced kidney function.
D. The glomerular filtration rate remains decreased during the oliguric phase.

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A nurse is caring for a client who has impaired renal function. For which of the following findings should the nurse notify the provider?

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Correct Answer is B

Explanation

A nurse is teaching a client who has acute kidney injury about the oliguric phase. Which of the following information should the nurse include in the teaching?

Correct Answer is A

Explanation

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