The client has passed a renal calculus that is determined to be composed of calcium oxalate. Which discharge instruction should be given by the nurse?

Increase sodium intake.

Consider a move to an area with higher humidity.

Increase water intake.

Decrease intake of all calcium-rich foods and beverages.

Answer and Explanation

The Correct Answer is C

Choice A Reason

Increasing sodium intake is not recommended for patients who have passed a calcium oxalate stone. High sodium intake can increase calcium in the urine, which can contribute to the formation of new stones. Therefore, patients are often advised to limit their sodium intake to reduce the risk of stone recurrence.

Choice B Reason

Considering a move to an area with higher humidity is not a standard recommendation for preventing the recurrence of calcium oxalate stones. While climate can affect hydration levels, it is more important for the patient to focus on direct measures to stay hydrated, such as drinking more fluids.

Choice C Reason

Increasing water intake is a key recommendation for patients who have had calcium oxalate stones. Adequate hydration is essential to dilute the urine, which helps prevent the formation of new stones. Patients are often advised to drink enough water to produce at least 2.5 liters of urine per day.

Choice D Reason

Decreasing the intake of all calcium-rich foods and beverages is not generally recommended for patients with calcium oxalate stones. In fact, a moderate intake of dietary calcium can help reduce the risk of stone formation by binding with oxalate in the intestines, which prevents it from being absorbed into the urine. Patients should consult with a healthcare provider or dietitian to determine the appropriate amount of dietary calcium.

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Correct Answer is A

Explanation

Choice A Reason:
Dantrolene is used in the management of malignant hyperthermia, a life-threatening complication characterized by muscle rigidity and elevated temperature, often triggered by certain anesthetics. The patient's symptoms of muscle rigidity and brown urine, which may indicate myoglobinuria, along with elevated temperature and heart rate, are suggestive of this condition. Dantrolene acts by reducing calcium release from the sarcoplasmic reticulum of skeletal muscle, thereby reducing muscle contraction and metabolic demand.

Choice B Reason:
Metoprolol, a beta-blocker, is not the first-line treatment for symptoms suggestive of malignant hyperthermia. While it can reduce heart rate and blood pressure, it does not address the underlying pathophysiology of malignant hyperthermia and is not indicated in this scenario.

Choice C Reason:
Increasing the rate of lactated Ringer's solution is not the primary intervention for malignant hyperthermia. While maintaining hydration is important, it does not directly counteract the pathophysiological processes at play in malignant hyperthermia.

Choice D Reason:
While liver function tests can be important in assessing overall organ function post-operatively, they are not the immediate priority in a suspected case of malignant hyperthermia. The priority is to treat the acute and life-threatening symptoms first.

A. Hemoglobin is 7.1 g/dL on today's laboratory report. B. There are small areas of ecchymosis on the client's upper extremities. C. Platelet count is 148,000/uL on today's laboratory report. D. The client complains of gastrointestinal discomfort after taking the medication.

Correct Answer is A

Explanation

Choice A Reason
A hemoglobin level of 7.1 g/dL is significantly lower than the normal range, which is typically around 13.8 to 17.2 g/dL for men and 12.1 to 15.1 g/dL for women. This finding is concerning as it indicates severe anemia, which can be a life-threatening condition requiring immediate intervention. Anemia can lead to tissue hypoxia as the blood's capacity to carry oxygen is diminished. In the context of peripheral arterial disease, where blood flow is already compromised, anemia can exacerbate symptoms and increase the risk of ischemic events.

Choice B Reason
Ecchymosis, or bruising, on the client's upper extremities could be a result of the antiplatelet effects of aspirin, which inhibits platelet aggregation and prolongs bleeding time. While this is a concern and warrants monitoring, it is not as immediately life-threatening as severe anemia. However, it does indicate a risk of bleeding complications, which should be addressed by the healthcare provider.

Choice C Reason
A platelet count of 148,000/uL is at the lower end of the normal range, which is approximately 150,000 to 450,000 platelets per microliter of blood. This finding should be monitored, especially in the context of aspirin therapy, which can affect platelet function. However, it is not as critical as the low hemoglobin level.

Choice D Reason
Gastrointestinal discomfort is a common side effect of aspirin due to its irritation of the stomach lining. While this symptom can be uncomfortable and may lead to more serious gastrointestinal issues such as ulcers or bleeding, it is typically not as urgent as severe anemia. The client should be evaluated for potential gastrointestinal complications of aspirin therapy.

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The client has passed a renal calculus that is determined to be composed of calcium oxalate. Which discharge instruction should be given by the nurse?

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Explanation

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