A nurse is caring for a client who recently had a streptococcal infection of the throat, and is now experiencing new-onset flank pain. Urinalysis is positive for proteinuria and hematuria. The client's urine output for the past 24 hours has been 250 mL, and BUN and creatinine are elevated. On assessment, the nurse notes pitting edema to the bilateral lower extremities. Which of the following interventions is appropriate in the plan of care?
Encourage frequent ambulation.
Obtain weight weekly.
Place the client on a low-protein diet.
Encourage increased fluid intake.
The Correct Answer is B
A. Frequent ambulation could exacerbate the edema and is not a priority in the acute management of this condition.
B. Obtaining weight weekly is an appropriate intervention to monitor for changes in fluid status and guide treatment decisions.
C. A low-protein diet is not a standard treatment for PSGN.
D. Encouraging increased fluid intake is not recommended due to the client's oliguria and risk of fluid overload
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Related Questions
Correct Answer is C
Explanation
A. While this medication is used to treat hyperkalemia, it is a slower acting treatment. Given the patient's critical condition with altered mental status, hyperkalemia, and elevated BUN, a more rapid intervention is needed.
B. Fluid resuscitation is important in some cases of AKI but it is not the priority in this patient. The patient is already showing signs of fluid overload (crackles in the lungs) and the primary issue is the inability of the kidneys to remove waste products and excess fluids.
C. This is the most appropriate treatment for this patient. RRT, such as hemodialysis or continuous renal replacement therapy (CRRT), can rapidly remove waste products, excess fluid, and electrolytes from the blood, correcting the imbalances and improving the patient's condition.
D. This medication is used for long-term management of hyperkalemia, but it is not effective in an acute setting like this.
Correct Answer is ["4"]
Explanation
To administer a total daily dose of 200 mg of imipramine divided equally every 12 hours, the nurse would need to give two doses of 100 mg each. Since the available tablets are 25 mg each, four tablets would be required to make up a single dose of 100 mg.
Therefore, the nurse should administer four tablets every 12 hours to meet the prescribed daily dosage.
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