A nurse is monitoring an older adult female client who had a myocardial infarction (MI) for the development of acute kidney injury (AKI). Which of the following findings should the nurse identify as indicating an increased risk of AKI?
Serum creatinine 1.8 mg/dL
Blood urea nitrogen (BUN) 200 mg/dL
Serum osmolality 290 mOsm/kg H2O
Magnesium 2.0 mEq/L
Correct Answer : A,B
Choice A reason: The normal range for serum creatinine in adult females is approximately 0.6–1.1 mg/dL. A level of 1.8 mg/dL is elevated and indicates impaired kidney function, which is a risk factor for AKI.
Choice B reason: Normal BUN levels are generally between 6 to 24 mg/dL⁸. A BUN level of 200 mg/dL is significantly elevated and suggests kidney dysfunction, which can lead to AKI.
Choice C reason: Serum osmolality in the normal range, which is typically between 275 to 295 mOsm/kg H2O for adults⁹[13][^10^][14][16], does not indicate an increased risk of AKI.
Choice D reason: The normal range for serum magnesium is typically 1.7 to 2.2 mg/dL or 0.85 to 1.10 mmol/L. A level of 2.0 mEq/L (which is equivalent to 2.0 mg/dL) is within the normal range and does not indicate an increased risk for AKI.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason: Muscle spasms are not typically associated with aluminum hydroxide use.
Choice B reason: Constipation is a common adverse effect of aluminum hydroxide, especially when used as a
phosphate binder in clients with renal failure.
Choice C reason: Headaches are not commonly reported as an adverse effect of aluminum hydroxide.
Choice D reason: A metallic taste is not a common adverse effect associated with aluminum hydroxide.
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.
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