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

Answer and Explanation

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.

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Correct Answer is D

Explanation

Choice A reason: A BUN level of 8 mg/dL and a creatinine level of 0.7 mg/dL are within normal ranges for healthy individuals. In CKD, BUN and creatinine levels are typically elevated due to decreased kidney function.

Choice B reason: A BUN level of 45 mg/dL is elevated, which could be expected in CKD, but a creatinine level of 8 ng/dL is not correctly expressed. Creatinine is measured in mg/dL, and in CKD, it would be higher than normal, not lower.

Choice C reason: A BUN level of 10 mg/dL and a creatinine level of 0.3 mg/dL are both lower than what would typically be expected in a patient with CKD. CKD usually results in higher levels due to reduced kidney function.

Choice D reason: A BUN level of 23 mg/dL and a creatinine level of 1.0 mg/dL are more aligned with what might be expected in CKD. Normal BUN levels range from 7 to 20 mg/dL, and normal creatinine levels can vary based on age, sex, and body size. In CKD, both levels tend to be higher as the kidneys' ability to filter blood decreases.

A. You should warm the dialysate in a microwave oven before instillation. B. You should anticipate pain during the first week of the inﬂow of dialysate. C. You should expect redness at the catheter exit site. D. You should avoid foods high in fiber. E. None of the above.

Correct Answer is E

Explanation

Choice A reason: Warming the dialysate in a microwave oven is not recommended because uneven heating could occur, leading to hot spots that can burn the peritoneal cavity. The dialysate should be warmed to body temperature using a warming device designed for this purpose.

Choice B reason: While some discomfort may be experienced during the first few exchanges, significant pain is not expected. If pain occurs, it should be reported to a healthcare provider, as it may indicate an underlying problem.

Choice C reason: Redness at the catheter exit site is not a normal expectation and could indicate an infection. The site should be kept clean and dry, and any signs of redness, swelling, or discharge should be reported to a healthcare provider immediately.

Choice D reason: There is no need to avoid foods high in fiber unless otherwise advised by a healthcare provider. In fact, a diet high in fiber can be beneficial for bowel regularity, which is important for patients on peritoneal dialysis.

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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?

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Naxlex Comprehensive Predictor Exams

A nurse is reviewing the BUN and creatinine levels of an older adult client who has chronic kidney disease (CKD). The nurse should expect which of the following findings?

Correct Answer is D

Explanation

A nurse is providing discharge teaching for a client who is to perform peritoneal dialysis at home. Which of the following information should the nurse include?

Correct Answer is E

Explanation

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