The nurse correlates which rationale with the administration of aspirin to the client experiencing angina-like chest pain?

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.

Choice A reason: A blood pressure of 158/90 mm Hg in a patient with chronic kidney disease (CKD) is elevated and requires management to prevent complications. However, it is not as immediately life-threatening as Kussmaul respirations, which indicate severe metabolic acidosis.

Choice B reason: The patient with Kussmaul respirations should be assessed first. Kussmaul respirations are deep, labored breathing patterns typically associated with severe metabolic acidosis, such as diabetic ketoacidosis (DKA) or severe kidney failure. This condition requires immediate intervention to correct the underlying acidosis and stabilize the patient's condition.

Choice C reason: Itching (pruritus) is a common symptom in CKD due to the accumulation of uremic toxins. While it can be very uncomfortable and requires treatment, it is not as urgent as Kussmaul respirations, which indicate a potentially life-threatening situation.

Choice D reason: Halitosis (bad breath) and stomatitis (inflammation of the mouth) can occur in CKD due to the buildup of uremic toxins and other factors. These symptoms need attention, but they do not indicate an immediate threat to the patient's life compared to Kussmaul respirations.