The nurse is caring for a patient with chronic kidney disease (CKD) who is at risk for renal osteodystrophy. Which intervention will the nurse implement to manage this condition?
Administer phosphate binders with meals.
Encourage the patient to increase potassium-rich foods.
Monitor calcium levels for signs of hypocalcaemia.
Increase fluid intake to 3 litters per day.
The Correct Answer is A
Choice A reason: Administering phosphate binders with meals is an essential intervention for managing renal osteodystrophy in patients with chronic kidney disease (CKD). Renal osteodystrophy results from an imbalance of calcium and phosphate in the body due to impaired kidney function. Phosphate binders help reduce the absorption of phosphate from the diet, thereby lowering serum phosphate levels and preventing complications such as secondary hyperparathyroidism and bone disorders. This intervention helps maintain the proper balance of minerals, improving bone health and reducing the risk of fractures and other skeletal complications in CKD patients.
Choice B reason: Encouraging the patient to increase potassium-rich foods is not appropriate for managing renal osteodystrophy. Patients with CKD often need to limit their potassium intake because impaired kidney function can lead to hyperkalaemia (elevated potassium levels), which is potentially life-threatening. Instead of promoting potassium-rich foods, the focus should be on controlling phosphate and maintaining calcium levels.
Choice C reason: Monitoring calcium levels for signs of hypocalcaemia is important in CKD management, but it is not the primary intervention for renal osteodystrophy. While hypocalcaemia can occur in CKD due to disrupted vitamin D metabolism, addressing phosphate levels through the use of phosphate binders is a more targeted approach to managing renal osteodystrophy and preventing secondary hyperparathyroidism.
Choice D reason: Increasing fluid intake to 3 litters per day is generally not recommended for CKD patients, especially those with reduced urine output or fluid retention issues. Excessive fluid intake can lead to fluid overload, hypertension, and heart failure in CKD patients. The intervention should focus on phosphate control rather than fluid intake adjustments.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
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.
Correct Answer is B
Explanation
Choice A reason: Kussmaul breathing is a sign of metabolic acidosis, not metabolic alkalosis. It is characterized by deep, labored breathing as the body tries to expel excess carbon dioxide.
Choice B reason: Positive Chvostek sign is an indication of hypocalcemia, which can be associated with metabolic alkalosis. It is a facial muscle twitch that occurs when the facial nerve is tapped.
Choice C reason: Hematemesis, or vomiting blood, is not a clinical manifestation of metabolic alkalosis. It is more related to gastrointestinal bleeding.
Choice D reason: Distended jugular veins are more commonly associated with conditions such as heart failure and fluid overload, not specifically with metabolic alkalosis.
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