A nurse is planning care for a client with acute renal failure. What is the priority nursing intervention for this client?
Administering prescribed medications to manage fluid balance.
Monitoring intake and output to assess kidney function.
Providing emotional support to cope with the sudden diagnosis.
Implementing measures to prevent infection and complications.
The Correct Answer is B
A. Incorrect. While administering prescribed medications is important, the priority in acute renal failure is to closely monitor the client's intake and output to assess kidney function and fluid balance.
B. Correct. Monitoring intake and output is a priority nursing intervention in acute renal failure. Accurate assessment of urine output helps determine the client's kidney function and the effectiveness of treatment.
C. Incorrect. Providing emotional support is essential, but it is not the priority over monitoring kidney function and fluid balance.
D. Incorrect. Preventing infection and complications is important, but it is not the priority over assessing kidney function in acute renal failure.
QUESTIONS
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. Incorrect. Encouraging the client to sit up in a chair for extended periods can increase pressure on certain areas and contribute to skin breakdown.
B. Incorrect. Applying a heating pad to areas at risk for skin breakdown can lead to thermal injury and exacerbate skin issues.
C. Correct. Regular repositioning and skin assessments are essential in preventing pressure ulcers and maintaining skin integrity in clients with acute renal failure who may be bedridden or have limited mobility.
D. Incorrect. Adhesive tape can cause skin irritation and damage when removed, especially in clients at risk for impaired skin integrity.
Correct Answer is B
Explanation
A. Incorrect. A complete blood count (CBC. provides information about the number and types of blood cells but does not assess kidney function.
B. Correct. Serum creatinine level is a commonly used blood test to assess kidney function. Elevated levels of creatinine in the blood indicate impaired glomerular filtration and decreased kidney function.
C. Incorrect. Urinalysis provides information about the presence of substances such as protein, blood, and glucose in the urine but does not directly assess GFR.
D. Incorrect. Renal ultrasound is an imaging test that provides information about the structure of the kidneys but does not directly measure GFR.
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