A nurse is responsible for screening client’s history for risk factors for possible complications.

Vital signs

BP 188/93

P 80
A nurse is correlating data documented in a client's medical history. The nurse should recognize that which client data indicates risk factors for acute kidney injury? (Select all that apply.)

low serum albumin

Renal Calculi

Hypertension

Hypovolemia

ineffective wound healing

Answer and Explanation

Correct Answer : B,C,D

A. Low serum albumin: While low albumin indicates poor nutrition or liver disease, it's not a direct cause of AKI.

B. Renal Calculi: Can cause obstruction in the urinary tract, leading to post-renal AKI.

C. Hypertension: Chronic high BP damages renal vasculature, increasing AKI risk.

D. Hypovolemia: Decreased perfusion leads to prerenal AKI.

E. Ineffective wound healing: Indicates poor nutrition or infection, but is not a primary AKI risk factor.

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Correct Answer is B

Explanation

A. Increased appetite: Not typical in AKI; anorexia is more common.

B. Elevated serum creatinine levels: A hallmark of AKI, indicating reduced kidney filtration capacity.

C. Hyperglycemia: Not a direct indicator of AKI, though may occur in diabetics.

D. Increased urine output: AKI is typically oliguric (low urine output) or anuric in early phases.

A. Place the drainage bag above the level of the client's abdomen. B. Warm the dialysate solution prior to instillation. C. Monitor vital signs every 2 hours during the procedure. D. Maintain the client in a left lateral position during dialysis.

Correct Answer is B

Explanation

A. Place the drainage bag above the level of the client's abdomen: This would impede drainage by gravity. The drainage bag should be below abdominal level to promote outflow.

B. Warm the dialysate solution prior to instillation: Warming the solution enhances diffusion, promotes comfort, and prevents abdominal cramping. Use a warming pad, not a microwave.

C. Monitor vital signs every 2 hours during the procedure: While vital signs are monitored, more frequent monitoring is often required during the initial phase or if the patient is unstable.

D. Maintain the client in a left lateral position during dialysis: The semi-Fowler’s position is preferred to facilitate flow and lung expansion, not lateral positioning.

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Naxlex Comprehensive Predictor Exams

A 65-year-old patient is admitted to the hospital with complaints of decreased urine output, fatigue, and swelling in the legs. Which of the following clinical cues is most indicative of acute kidney injury?

Correct Answer is B

Explanation

A nurse is developing a plan of care for a client who is to begin receiving peritoneal dialysis. Which of the following interventions should the nurse Implement to ensure proper dialysate exchange?

Correct Answer is B

Explanation

A nurse is caring for a client who has a new arteriovenous (AV) graft in his left forearm. Which of the following techniques should the nurse use to assess the patency of this graft?

A nurse is caring for a client receiving sodium polystyrene sulfonate (Kayexalate) for the treatment of chronic renal disease. The nurse should monitor for which therapeutic effect of sodium polystyrene sulfonate (Kayexalate)?

A nurse is collecting a medication history from a client who is scheduled to have a cardiac catheterization. The nurse should recognize that which of the following medications taken by the client interacts with contrast material, and places the client at risk for acute kidney injury (AKI)?

A client has been admitted to a burn intensive care unit with extensive full thickness burns over 36% of the body. After ensuring cardiopulmonary stability, which should be the nurse's highest priority when planning the client's care in the early acute phase of the injury?

A nurse is caring for a client with 45% total body surface area (TBSA) thermal burns. During the emergent, initial phases of burn shock the nurse should closely monitor for which electrolyte imbalance?

A nurse is caring for a client who has acute kidney injury (AKI). Which of the following arterial blood gas values would the nurse expect this client to have?

Patient presented for follow up of major burn injury. Exhibits A nurse is caring for a client recovering for 12 months from major burns that affected 60% total body surface area (TBSA). Which of the following complications should the nurse expect? (Select all that apply)