A nurse is caring for a client who has polycystic kidney disease (PKD). The client is admited to the hospital for renal calculi and reports that their abdomen has been getting bigger. Which of the following statements by the nurse is the best explanation for the increase in abdominal girth?
"The kidney infection has caused narrowing of the ureters, and your abdomen has filled with fluid."
"The kidneys continue to enlarge due to the cysts growing, which increases the girth of your abdomen."
"The stones might descend into the ureters, blocking the flow of urine and causing an increase in the girth of your abdomen."
"The in?ammation in your kidneys damages the filtration system, which causes fluid retention in your abdomen."
The Correct Answer is B
Choice A reason: While kidney infections can cause swelling, they typically do not lead to a significant increase in abdominal girth unless associated with severe obstruction or advanced kidney disease.
Choice B reason: In PKD, the kidneys can become significantly enlarged due to the growth of numerous cysts, which
can indeed lead to an increase in abdominal girth.
Choice C reason: While stones can cause blockage and swelling, they would not typically result in a generalized increase in abdominal girth unless there is an associated infection or severe obstruction.
Choice D reason: Inflammation can lead to fluid retention, but in the context of PKD, it is the cysts' growth that primarily contributes to increased kidney size and abdominal girth.
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Correct Answer is B
Explanation
Choice A reason: Aluminum hydroxide does not primarily lower serum calcium levels. Calcium levels are typically managed in CKD patients through other medications and dietary restrictions, as hypercalcemia can occur in these patients.
Choice B reason: Aluminum hydroxide acts as a phosphate binder, which helps to lower serum phosphorus levels in patients with CKD. This is important because high phosphorus levels can lead to bone and heart problems in these patients. The normal range for serum phosphorus is approximately 2.5 to 4.5 mg/dL.
Choice C reason: Aluminum hydroxide does not have a significant effect on serum potassium levels. In CKD, potassium levels are managed through diet and other medications due to the risk of hyperkalemia, which can be life- threatening.
Choice D reason: While magaldrate contains magnesium, which could potentially worsen hypermagnesemia in CKD patients, aluminum hydroxide does not lower serum magnesium levels. Instead, it is less likely to cause elevated magnesium levels compared to magaldrate.
Correct Answer is C
Explanation
Choice A reason: Renal failure is typically associated with abnormal creatinine and BUN levels, which are not
indicated in the given lab values.
Choice B reason: A low-protein diet is not directly indicated by the lab values provided and does not typically result in
collapse after exertion.
Choice C reason: Dehydration is consistent with the client's history of collapsing after playing football on a hot day
and is supported by the elevated sodium level.
Choice D reason: SIADH usually presents with low sodium levels due to dilution, which is not the case here.
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