The nurse is admitting a patient who was diagnosed with acute renal failure. Which electrolyte should the nurse expect to be most affected with this disorder?

Phosphorous.

Magnesium.

Potassium.

Calcium.

Answer and Explanation

The Correct Answer is C

Choice A rationale:

While acute renal failure can affect phosphorus levels, potassium is the electrolyte most commonly affected in this condition. Kidneys play a crucial role in regulating potassium levels in the body, and when they fail, potassium levels can become dangerously elevated.

Choice B rationale:

Acute renal failure can lead to alterations in magnesium levels, but potassium is typically more affected. Magnesium imbalances may occur but are not the primary concern in this condition.

Choice C rationale:

As mentioned earlier, potassium imbalances are common in acute renal failure. The nurse should closely monitor the patient's potassium levels and be prepared to intervene if they become too high or too low.

Choice D rationale:

Calcium levels may also be affected in acute renal failure, but potassium remains the most critical electrolyte to monitor in this condition.

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Correct Answer is D

Explanation

The correct answer isd. Assess for indications of pulmonary embolism.

Choice A rationale:

Administering a sedative is not appropriate as the priority intervention. Sedatives can depress respiratory function, which is already compromised in this patient.

Choice B rationale:

Preparing for mechanical ventilation might be necessary if the patient’s condition worsens, but it is not the immediate priority. The priority is to identify the underlying cause of the symptoms.

Choice C rationale:

Massaging the calf area for tenderness is not relevant in this context. While calf tenderness can be a sign of deep vein thrombosis (DVT), which can lead to pulmonary embolism, the immediate priority is to assess for pulmonary embolism directly.

Choice D rationale:

Assessing for indications of pulmonary embolism is the priority because the patient’s symptoms (shortness of breath, chest pain, recent use of birth control pills, smoking history, and abnormal ABG values) strongly suggest a pulmonary embolism.Early identification and treatment are crucial to prevent further complications.

A. Distended neck veins. B. Poor skin turgor. C. Concentrated hemoglobin and hematocrit levels. D. Decreased urine output.

Correct Answer is A

Explanation

Choice A rationale:

Fluid volume overload is an excess of fluid in the intravascular and/or interstitial spaces. One of the hallmark signs of fluid volume overload is distended neck veins, which indicates increased venous pressure due to the accumulation of fluid. The neck veins become more visible and prominent, especially when the patient is in a semi-Fowler's position.

Choice B rationale:

Poor skin turgor is a sign of dehydration, not fluid volume overload. It is characterized by the skin's inability to return to its normal position after being gently pinched. In fluid volume overload, the skin may become edematous and puffy, but it does not exhibit poor turgor.

Choice C rationale:

Concentrated hemoglobin and hematocrit levels are seen in conditions of dehydration or hemoconcentration, not in fluid volume overload. In fluid volume overload, there is excess fluid, which may lead to dilutional effects, resulting in decreased concentration of blood components.

Choice D rationale:

Decreased urine output is associated with fluid volume deficit (dehydration) rather than fluid volume overload. In fluid volume overload, there is often an increase in urine output as the body tries to eliminate the excess fluid.

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The nurse is admitting a patient who was diagnosed with acute renal failure. Which electrolyte should the nurse expect to be most affected with this disorder?

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Correct Answer is D

Explanation

A postoperative patient is diagnosed with fluid volume overload. What should the nurse expect to assess in this patient?

Correct Answer is A

Explanation

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