Exhibits
Select the top 5 client findings that require immediate follow-up
Abdomen rigid with decreased bowel sounds
Glucose 220mg/d
No dialysis for 24 hours
Crackles throughout the lungs
WBC 17,000 mm3
Hemoglobin 10g/dL
Potassium 7mEq/L
Creatinine 3 mg/dL
Correct Answer : A,B,D,E,G
A. Abdomen rigid with decreased bowel sounds: A rigid, tender abdomen suggests peritonitis, a life-threatening complication of peritoneal dialysis requiring immediate intervention.
B. Glucose 220 mg/Dl: Elevated glucose is concerning but not immediately life-threatening compared to the other findings.
C. No dialysis for 24 hours: Missing dialysis leads to toxin accumulation, hyperkalemia, and fluid overload, all of which can be life-threatening.
D. Crackles throughout the lungs: Fluid overload can cause pulmonary edema, leading to respiratory distress. Immediate intervention is needed to prevent respiratory failure.
E. WBC 17,000 mm³: Leukocytosis suggests infection, possibly peritonitis, which requires urgent antibiotic therapy.
F. Hemoglobin 10 g/dL: Mild anemia is expected in CKD and not an emergency.
G. Potassium 7 mEq/L: Severe hyperkalemia is a medical emergency due to the risk of life-threatening cardiac arrhythmias.
H. Creatinine 3 mg/dl: Creatinine is chronically elevated in CKD and not an acute concern.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Electrolytes are within normal limits: Acute Renal Failure (ARF) leads to electrolyte imbalances (↑ K+, ↑ BUN/creatinine, metabolic acidosis). A successful treatment goal is restoring normal electrolyte balance.
B. Blood pressure is decreased to 120/80. BP control is important but not the primary goal in ARF.
C. Decrease of pain by 3 points on a 1-10 scale. Pain control is important, but not the main indicator of ARF improvement.
D. The client will understand how to care for the AV fistula. This applies to chronic kidney disease clients on hemodialysis, not ARF management.
Correct Answer is D
Explanation
A. Respiratory Acidosis: Respiratory acidosis results from inadequate ventilation leading to CO₂ retention, which is unrelated to kidney failure.
B. Metabolic Alkalosis: Metabolic alkalosis occurs due to excessive loss of acids (e.g., vomiting) or excess bicarbonate intake. Acute renal failure causes acid retention, not loss.
C. Respiratory Alkalosis: Respiratory alkalosis is caused by hyperventilation and excessive CO₂ loss, not renal dysfunction.
D. Metabolic acidosis: The kidneys play a vital role in acid-base balance by excreting hydrogen ions and reabsorbing bicarbonate. Acute renal failure impairs these functions, leading to acid retention and metabolic acidosis.
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