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 C
Explanation
A. Administer scheduled medications: Some medications (e.g., antihypertensives, water-soluble vitamins, and antibiotics) should be held before dialysis to prevent removal during treatment.
B. Explain that dialysis occurs via the peritoneum: This describes peritoneal dialysis, not hemodialysis.
C. Weigh the client to determine a baseline for comparison: Pre-dialysis weight is crucial to determine fluid removal needs during dialysis. Weight differences before and after dialysis indicate fluid loss or retention.
D. Obtain a serum creatinine to determine kidney function: Serum creatinine levels are monitored regularly but are not a required step before every dialysis session.
Correct Answer is D
Explanation
A. Decreases the chance of peptic ulcer formation: Calcium carbonate is not an antiulcer medication.
B. Prevents constipation: Calcium carbonate can cause constipation, not prevent it.
C. Increases the tubular excretion of potassium: Calcium carbonate does not directly affect potassium excretion.
D. To lower phosphorus levels: Calcium carbonate is a phosphate binder that reduces phosphorus absorption from food. In chronic renal failure, phosphorus builds up due to decreased kidney excretion, leading to secondary hyperparathyroidism and bone disease (renal osteodystrophy).
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