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 D
Explanation
A. Respiratory Alkalosis: Would have high pH (>7.45) and low PaCO2 (<35 mmHg).
B. Metabolic Acidosis: Would have low pH and low HCO3 (<22 mEq/L).
C. Metabolic Alkalosis: Would have high pH and high HCO3 (>26 mEq/L).
D. Respiratory Acidosis: A low pH (<7.35) and high PaCO2 (>45 mmHg) indicate respiratory acidosis, which occurs due to hypoventilation, COPD, or respiratory failure. The bicarbonate (HCO3) is normal, meaning there is no metabolic compensation yet.
Correct Answer is B
Explanation
A. pH 7.30, PaCO₂ 38, HCO₃ 15: Metabolic acidosis (low HCO₃, normal PaCO₂).
B. pH 7.32, PaCO₂ 56, PO₂ 84, HCO₃ 26: The client has respirations of 8/min, which indicates hypoventilation → CO₂ retention → respiratory acidosis. pH 7.32 indicates acidosis. PaCO₂ 56 mmHg - Elevated CO₂ (hypercapnia), confirming respiratory acidosis. HCO₃ 26- Normal bicarbonate suggests that compensation has not yet occurred
C. pH 7.37, PaCO₂ 45, HCO₃ 24: Normal ABG values.
D. pH 7.48, PaCO₂ 32, HCO₃ 22: Respiratory alkalosis (low PaCO₂ due to hyperventilation, not hypoventilation).
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