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During a preoperative review of systems, the client reveals a history of renal disease. This finding suggests the need for which relevant preoperative diagnostic tests?

A.

Serum glucose and a Complete Blood Count

B.

Arterial blood gas and coagulation tests

C.

Serum creatinine and a Basic Metabolic Panel

D.

Chest X-ray and cardiac enzymes

Answer and Explanation

The Correct Answer is C

A. Serum glucose and a Complete Blood Count: While a complete blood count (CBC) is useful in assessing overall health, serum glucose is less relevant in the context of renal disease. The focus should be on kidney function rather than glucose levels.
B. Arterial blood gas and coagulation tests: Arterial blood gas (ABG) and coagulation tests may be important for other conditions, but they are not specifically targeted to evaluate renal function or related preoperative risks in renal disease.
C. Serum creatinine and a Basic Metabolic Panel: This is the correct choice as serum creatinine is a key marker of kidney function, and a Basic Metabolic Panel (BMP) provides information on electrolyte levels and overall metabolic status, which are crucial in evaluating the impact of renal disease on surgery.
D. Chest X-ray and cardiac enzymes: These tests are more relevant for evaluating cardiac function and lung status rather than directly assessing kidney function, which is the primary concern in the context of renal disease.
 


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Related Questions

Correct Answer is C

Explanation

A. Capillary refill and depth of peripheral edema: While these assessments are important for evaluating peripheral circulation and fluid status, they are not as immediately critical given the client's new onset of confusion and respiratory symptoms.
B. Abdominal sounds and obtain a BNP level: Assessing abdominal sounds and BNP (B-type natriuretic peptide) levels is useful for diagnosing heart failure exacerbations but is secondary to addressing the client's acute confusion and potential electrolyte imbalances.
C. Neurological status and obtain electrolyte levels: This is the correct choice. New onset confusion can be indicative of electrolyte imbalances or acute exacerbations related to heart failure. Monitoring neurological status and electrolyte levels is crucial to address potential causes of confusion and ensure proper treatment.
D. Skin turgor and measure intake & output (I&O): While skin turgor and I&O are relevant for assessing fluid status, the priority should be addressing the acute change in mental status and potential underlying causes such as electrolyte imbalances.

Correct Answer is D

Explanation

A. Neuromuscular blockers: These are used to induce paralysis and do not affect consciousness or maintain reflexes such as the gag reflex.
B. Inhaled general anesthesia: Generally, inhaled general anesthesia suppresses all reflexes, including the gag reflex.
C. Intravenous general anesthesia: This type of anesthesia typically induces a loss of consciousness and suppression of reflexes, including the gag reflex.
D. Regional anesthesia: This type of anesthesia blocks sensation in a specific area of the body while the client remains conscious and retains reflexes, including the gag reflex.

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