The nurse is caring for a patient with a history of chronic kidney disease who was admitted with hypervolemia. As part of discharge planning, which instruction will the nurse provide to help the patient accurately monitor their fluid balance?

Monitor your blood pressure weekly.

Limit your fluid intake to 3 liters per day.

Weigh yourself at the same time each day.

Increase your daily sodium intake to balance your fluids.

Answer and Explanation

The Correct Answer is C

Choice A reason: Monitoring blood pressure weekly is important but does not directly help the patient accurately monitor their fluid balance. Daily weight monitoring provides more immediate feedback on fluid status changes.

Choice B reason: Limiting fluid intake to 3 liters per day may be appropriate for some patients but does not directly help the patient monitor their fluid balance. Accurate fluid monitoring involves tracking intake, output, and changes in body weight.

Choice C reason: Weighing yourself at the same time each day is crucial for accurately monitoring fluid balance. Daily weights provide consistent and immediate information about changes in fluid status, which is essential for managing hypervolemia in patients with chronic kidney disease.

Choice D reason: Increasing daily sodium intake is not appropriate for patients with hypervolemia, as it can lead to further fluid retention and worsen the condition. The focus should be on reducing sodium intake and monitoring fluid balance.

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Correct Answer is A

Explanation

Choice A reason: The lab results pH 7.46, PaCO2 30, HCO3 24 indicate respiratory alkalosis, which can occur due to hyperventilation. In pulmonary edema, the patient may hyperventilate to compensate for reduced oxygenation, leading to a decrease in carbon dioxide (PaCO2) and an increase in pH (alkaline).

Choice B reason: The lab results pH 7.48, PaCO2 45, HCO3 29 indicate metabolic alkalosis with partial compensation. This is not consistent with hyperventilation in pulmonary edema, where respiratory alkalosis is more likely.

Choice C reason: The lab results pH 7.26, PaCO2 59, HCO3 30 indicate respiratory acidosis with partial compensation. This finding suggests hypoventilation, which is not expected in a patient hyperventilating due to pulmonary edema.

Choice D reason: The lab results pH 7.31, PaCO2 34, HCO3 18 indicate metabolic acidosis with partial compensation. This is not typical in a patient with hyperventilation and pulmonary edema.

A. The patient is increasingly drowsy and hard to arouse. B. The patient's feet and hands are covered with red, raised purpura.

Correct Answer is A

Explanation

Choice A reason: The patient being increasingly drowsy and hard to arouse is an urgent finding that should be reported immediately. This condition may indicate intracranial bleeding or other severe complications related to extremely low platelet count (10,000/mm³) in idiopathic thrombocytopenic purpura (ITP). Immediate medical intervention is required to prevent further deterioration.

Choice B reason: Red, raised purpura on the patient's feet and hands is a concerning finding indicative of significant thrombocytopenia, but it is not as immediately life-threatening as decreased consciousness. It should still be monitored and managed, but the priority is the patient's level of consciousness.

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The nurse is caring for a patient with a history of chronic kidney disease who was admitted with hypervolemia. As part of discharge planning, which instruction will the nurse provide to help the patient accurately monitor their fluid balance?

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Naxlex Comprehensive Predictor Exams

The nurse is admitting a patient with pulmonary edema resulting from heart failure. Upon assessment, the nurse notes that the patient is hyperventilating. What lab results will the nurse expect to see?

Correct Answer is A

Explanation

The nurse is caring for a patient with idiopathic thrombocytopenic purpura (ITP) whose platelet count is 10,000/mm³. What assessment finding will the nurse report to the provider immediately?

Correct Answer is A

Explanation

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