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The 75-year-old client is hospitalized with end-stage chronic kidney disease. Which of the following serum lab findings would the nurse expect? Select all that apply.

Decreased calcium.

Decreased BUN.

Decreased hemoglobin.

Decreased potassium.

Elevated creatinine.

Increased phosphorus.

Decreased glomerular filtration rate (GFR).

Answer and Explanation

Correct Answer : A,C,E,F,G

Choice A reason: Decreased calcium is expected in end-stage chronic kidney disease (CKD) due to impaired kidney function. The kidneys are responsible for converting vitamin D into its active form, which helps in calcium absorption. Reduced kidney function leads to decreased active vitamin D, resulting in lower calcium levels.

Choice B reason: Decreased blood urea nitrogen (BUN) is not typical in CKD. Instead, BUN levels usually increase because the kidneys are less able to remove urea from the blood. Urea is a waste product of protein metabolism, and elevated BUN is indicative of impaired kidney function.

Choice C reason: Decreased hemoglobin is expected in CKD due to reduced production of erythropoietin by the kidneys. Erythropoietin stimulates the production of red blood cells, and a lack of it leads to anemia, reflected by lower hemoglobin levels.

Choice D reason: Decreased potassium is not typically seen in CKD. In fact, potassium levels often increase because the kidneys are less able to excrete it. Hyperkalemia (high potassium) is a common complication in CKD and requires careful monitoring.

Choice E reason: Elevated creatinine is expected in CKD. Creatinine is a waste product of muscle metabolism, and elevated levels indicate impaired kidney function as the kidneys are less able to clear it from the blood.

Choice F reason: Increased phosphorus is a common finding in CKD due to the kidneys' reduced ability to excrete phosphorus. This can lead to hyperphosphatemia, which can cause secondary hyperparathyroidism and further complications.

Choice G reason: Decreased glomerular filtration rate (GFR) is a hallmark of CKD. GFR measures how well the kidneys are filtering blood, and a lower GFR indicates reduced kidney function. It is used to stage the severity of CKD.

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Correct Answer is C

Explanation

Choice A reason: Aspirin does have analgesic properties, which help relieve pain. However, this is not the primary reason for its administration in the context of angina-like chest pain. The analgesic effect of aspirin without sedation is more relevant in the management of general pain or headaches.

Choice B reason: Vasoconstriction and improved blood flow are not effects of aspirin. In fact, aspirin's mechanism of action involves preventing platelet aggregation, which can indirectly improve blood flow by reducing the risk of clot formation. Vasoconstriction is not an effect associated with aspirin.

Choice C reason: The primary rationale for administering aspirin to a client with angina-like chest pain is its antiplatelet effect. Aspirin inhibits platelet aggregation, reducing the risk of clot formation. This is crucial in preventing further blockage of coronary arteries, which can exacerbate angina or lead to myocardial infarction.

Choice D reason: Cardiotonic properties and improved contraction are not associated with aspirin. Cardiotonic drugs enhance the strength of the heart's contractions, which is not an action of aspirin. Aspirin's role in this context is to prevent platelet aggregation and reduce the risk of clot-related complications.

A. pH 7.50, pO2 85, pCO2 35, HCO3 30 mEq/L B. pH 7.30, pO2 90, pCO2 35, HCO3 20 mEq/L C. pH 7.50, pO2 95, pCO2 25, HCO3 22 mEq/L D. pH 7.30, pO2 80, pCO2 55, HCO3 22 mEq/L

Correct Answer is D

Explanation

Choice A reason: The values pH 7.50, pO2 85, pCO2 35, HCO3 30 mEq/L indicate alkalosis with a high bicarbonate level, which is not consistent with the patient’s slow respiratory rate that would typically lead to respiratory acidosis.

Choice B reason: The values pH 7.30, pO2 90, pCO2 35, HCO3 20 mEq/L indicate metabolic acidosis with normal pCO2, which does not align with the respiratory issue described (hypoventilation).

Choice C reason: The values pH 7.50, pO2 95, pCO2 25, HCO3 22 mEq/L indicate respiratory alkalosis, which is characterized by a low pCO2. This is not consistent with the patient’s hypoventilation, which would lead to elevated pCO2 levels.

Choice D reason: The values pH 7.30, pO2 80, pCO2 55, HCO3 22 mEq/L indicate respiratory acidosis, which aligns with the patient’s hypoventilation due to anesthesia effects and incisional pain. The elevated pCO2 and decreased pH are consistent with reduced respiratory rate and shallow breathing.

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The 75-year-old client is hospitalized with end-stage chronic kidney disease. Which of the following serum lab findings would the nurse expect? Select all that apply.

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Naxlex Comprehensive Predictor Exams

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Explanation

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