In caring for a client with chronic kidney disease (CKD), the nurse notes that the client's serum phosphate level is elevated, with a converse decrease in serum calcium. Which nursing care goal is a priority, based on these laboratory findings?
Prevent injury.
Prevent infection.
Protect skin integrity.
Manage fluid volume.
The Correct Answer is A
Rationale:
A. Prevent injury: In CKD, high phosphate and low calcium levels contribute to bone demineralization, increasing fracture risk. Hypocalcemia can also cause muscle cramps and tetany, making fall prevention and safety a priority.
B. Prevent infection: While infection is a general concern in CKD, these specific lab findings do not indicate immunosuppression. The primary issue here relates to bone health and calcium-phosphate imbalance, not immune function.
C. Protect skin integrity: Skin care is important in CKD, especially with pruritus, but it is not the direct consequence of calcium-phosphate imbalance. The immediate risk related to these values is musculoskeletal, not dermatologic.
D. Manage fluid volume: Fluid volume control is essential in CKD but unrelated to phosphate-calcium shifts. These labs reflect mineral and bone metabolism disturbances, not volume overload or deficit.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is "{\"xRanges\":[68.3447994402985,73.94181436567165],\"yRanges\":[69.43765281173594,76.77261613691931]}"
Explanation
Rationale:
The second paddle should be placed on the left lateral chest, specifically:
- Below the left nipple
- At the mid-axillary line
- Over the apex of the heart
For anterior-lateral defibrillator pad placement, the standard positions are: Right of the sternum, just below the clavicle as shown in the image and left side of the chest, at the mid-axillary line, roughly at the level of V6 in ECG placement.
Correct Answer is A
Explanation
Rationale:
A. Arrange an appointment with a pain specialist: A pain specialist can provide comprehensive strategies for managing chronic pain related to fibromyalgia. This includes pharmacologic and non-pharmacologic options tailored to the client's needs.
B. Form an interdisciplinary team for evaluation: While helpful in complex cases, a full team may not be necessary as the first step. It may delay direct pain management support that a pain specialist could initiate more quickly. Interdisciplinary care may follow specialist input.
C. Contact a hospice nurse for an evaluation: Hospice care is intended for clients with terminal illnesses and a life expectancy of six months or less. Fibromyalgia is a chronic, non-fatal condition, so this request indicates a need for pain support, not end-of-life care.
D. Ask for a consultation with a psychologist: A psychologist can help address emotional responses to chronic pain, but cannot directly manage physical symptoms. This should be a supportive measure after physical pain is addressed by a medical pain expert.
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