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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 ["B","C","D"]

Explanation

Choice A reason: Deep vein thrombosis is a condition where blood clots form in the deep veins, usually in the legs. While it is a serious condition, it is not directly associated with portal hypertension in patients with late-stage cirrhosis. Portal hypertension primarily affects the liver and its associated blood vessels, leading to complications within the portal circulation system rather than systemic venous thrombosis.

Choice B reason: Ascites is the accumulation of fluid in the abdominal cavity, and it is a common complication of portal hypertension in patients with cirrhosis. Increased pressure in the portal vein leads to leakage of fluid into the abdominal cavity, causing distension and discomfort. Ascites can significantly impact the patient's quality of life and requires careful management.

Choice C reason: Splenomegaly, or enlargement of the spleen, is another potential complication of portal hypertension. The increased pressure in the portal vein can cause blood to back up into the spleen, leading to its enlargement. Splenomegaly can result in hypersplenism, where the spleen becomes overactive and destroys blood cells, contributing to anemia, thrombocytopenia, and leukopenia.

Choice D reason: Esophageal varices are dilated blood vessels in the esophagus that develop as a result of portal hypertension. The increased pressure in the portal vein causes blood to divert through collateral vessels, including those in the esophagus. These varices can rupture and cause life-threatening bleeding, making them a critical complication to monitor in patients with cirrhosis.

Choice E reason: Increased platelet levels are not typically seen in patients with portal hypertension. In fact, portal hypertension and cirrhosis often lead to thrombocytopenia, or low platelet levels, due to splenic sequestration and reduced platelet production. Thrombocytopenia is a more common finding in this patient population.

A. Encourage them to continue an exercise routine such as weightlifting. B. Advise them to avoid straining at stools. C. Provide them with hot liquids as desired. D. Advise them to limit himself to one alcoholic drink per day.

Correct Answer is B

Explanation

Choice A reason: Encouraging the patient to continue an exercise routine such as weightlifting is not appropriate for a patient with esophageal varices. Weightlifting and other strenuous activities can increase intra-abdominal pressure, which may lead to the rupture of the varices and cause severe bleeding.

Choice B reason: Advising the patient to avoid straining at stools is the correct intervention. Straining during bowel movements can increase intra-abdominal pressure and the risk of rupturing the esophageal varices. The nurse should encourage the patient to maintain soft stools through a high-fiber diet, adequate hydration, and possibly stool softeners to prevent straining.

Choice C reason: Providing hot liquids as desired is not recommended for patients with esophageal varices. Hot liquids can cause vasodilation and potentially increase the risk of bleeding from the varices. Patients should be advised to consume beverages at moderate temperatures.

Choice D reason: Advising the patient to limit themselves to one alcoholic drink per day is not appropriate. Alcohol consumption can worsen liver disease, increase portal hypertension, and exacerbate esophageal varices. Patients with esophageal varices should be advised to avoid alcohol completely to reduce the risk of complications.

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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

A patient with late-stage cirrhosis develops portal hypertension. All of the following are potential complications that can develop from this condition. Select all that apply.

Correct Answer is ["B","C","D"]

Explanation

Considering the patient's esophageal varices, which of the following nursing interventions would be appropriate in your care of the patient?

Correct Answer is B

Explanation

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