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 ["A","C","D"]
Explanation
Choice A reason: Ensuring the client's urine output is at least 1 mL/kg/hour is important before administering potassium to prevent hyperkalemia, especially in clients with renal impairment.
Choice B reason: While educating the client about high-potassium food sources is important, it is not directly related to the administration of intravenous potassium.
Choice C reason: Cardiac monitoring during infusion is crucial due to the risk of arrhythmias associated with rapid
changes in potassium levels.
Choice D reason: Repeating blood serum potassium is necessary to monitor the effectiveness of the supplementation and avoid hyperkalemia.
Choice E reason: Potassium should not be prepared with 5% dextrose solution as it may cause a trans-cellular shift of potassium into cells, which is not recommended.
Correct Answer is A
Explanation
Choice A reason: Diabetes can increase the risk of infection, including peritonitis, due to immune system impairment.
Choice B reason: Obesity may contribute to surgical complications but is not directly linked to an increased risk of peritonitis in the context of peritoneal dialysis.
Choice C reason: Hemochromatosis can affect many organs but is not directly linked to an increased risk of peritonitis in peritoneal dialysis.
Choice D reason: Ulcerative colitis affects the colon and is not directly linked to an increased risk of peritonitis in peritoneal dialysis.
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