A nurse is reviewing laboratory findings for four clients. Which of the following clients has manifestations of untreated chronic kidney disease?
Potassium 3.3 mEq/L. hemoglobin 14.1 g/dL, creatinine 0.8 mg/dL
BUN 5 mg/dL, potassium 4.8 mEq/L, creatinine 0.9 mg/dL
Potassium 5.4 mEq/L. hemoglobin 9.8 g/dL, creatinine 4.6 mg/dl.
Potassium 4.5 mEq/L, BUN 18 mg/dL, creatinine 1.1 mg/dL
The Correct Answer is C
A. These values are within normal ranges.
B. BUN is low, but potassium and creatinine are within normal ranges.
C. Elevated potassium (hyperkalemia), low hemoglobin (anemia), and elevated creatinine are all classic signs of chronic kidney disease.
D. BUN and creatinine are slightly elevated, but not to a level indicative of chronic kidney disease. Potassium is within normal range.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Hematocrit measures the proportion of blood volume that is occupied by red blood cells. Epoetin alfa stimulates red blood cell production, so a therapeutic effect would be indicated by an increase in hematocrit levels. This is a key laboratory result to monitor when assessing the effectiveness of epoetin alfa in treating anemia in CKD patients.
B. Serum potassium levels are important to monitor in CKD patients due to the risk of hyperkalemia, but they are not directly affected by epoetin alfa. Decreasing serum potassium is not a primary indicator of the therapeutic effect of epoetin alfa.
C. Platelet count measures the number of platelets in the blood, which are crucial for blood clotting. Epoetin alfa is not designed to affect platelet counts; thus, a change in platelet count is not an indicator of the medication's therapeutic effect.
D. White blood cell count reflects the immune system's status and is not directly influenced by epoetin alfa. This medication specifically targets red blood cell production and does not impact white blood cell counts.
Correct Answer is A
Explanation
A. This method is the most reliable for measuring fluid retention. Weight changes are a direct indicator of fluid balance because fluid retention or loss affects body weight. By comparing the client's current weight to their post-dialysis weight, you can determine the amount of fluid they have retained.
B. Creatinine and blood urea nitrogen (BUN) levels are indicators of kidney function rather than fluid volume status. Elevated levels can indicate worsening kidney function but do not directly measure fluid retention or overload.
C. While assessing skin turgor and peripheral edema can provide some clues about fluid overload, these signs are less precise and subjective compared to weight measurements. Skin turgor changes and edema can be influenced by various factors, including skin elasticity and other conditions, making them less reliable for accurately measuring fluid volume changes since the last dialysis.
D. Crackles in lung sounds can indicate pulmonary congestion due to fluid overload, but this method is not as precise for quantifying the amount of fluid retained. Crackles suggest fluid accumulation in the lungs, which is a sign of more severe fluid overload but does not provide a specific measurement of fluid volume compared to changes in body weight.
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