The nurse is developing a plan of care for a client diagnosed with acute renal failure (ARF). Which statement would be an appropriate outcome for the client?

Electrolytes are within normal limits.

Blood pressure is decreased to 120/80

Decrease of pain by 3 points on a 1-10 scale.

The client will understand how to care for the AV fistula

Answer and Explanation

The Correct Answer is A

A. Electrolytes are within normal limits: Acute Renal Failure (ARF) leads to electrolyte imbalances (↑ K+, ↑ BUN/creatinine, metabolic acidosis). A successful treatment goal is restoring normal electrolyte balance.

B. Blood pressure is decreased to 120/80. BP control is important but not the primary goal in ARF.

C. Decrease of pain by 3 points on a 1-10 scale. Pain control is important, but not the main indicator of ARF improvement.

D. The client will understand how to care for the AV fistula. This applies to chronic kidney disease clients on hemodialysis, not ARF management.

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Correct Answer is D

Explanation

A. Magnesium sulfate: Magnesium sulfate is used for eclampsia and torsades de pointes, not for reducing shivering.

B. Kayexalate: This medication is used for hyperkalemia, not temperature control.

C. Acetaminophen: While useful for fever, acetaminophen does not stop shivering.

D. Diazepam: Shivering increases metabolic demand and body temperature. Diazepam (a benzodiazepine) is a muscle relaxant that helps control shivering in hyperthermic clients.

A. Assess the fistula with a large bore needle B. Auscultate the fistula site for a bruit. C. Measure the blood pressure in the affected arm D. Assess the rate and quality of the radial pulse on the affected arm

Correct Answer is B

Explanation

A. Assess the fistula with a large bore needle: Large bore needles are used during dialysis sessions, not for routine assessment. Inappropriate needling can damage the fistula.

B. Auscultate the fistula site for a bruit: A functional AV fistula should have a palpable thrill (vibration) and an audible bruit (whooshing sound) when auscultated with a stethoscope. These findings confirm adequate blood flow and patency.

C. Measure the blood pressure in the affected arm: Blood pressure measurements should never be taken on the fistula arm to prevent compression and potential fistula failure.

D. Assess the rate and quality of the radial pulse on the affected arm: The radial pulse does not accurately assess AV fistula patency; the focus should be on the thrill and bruit.

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The nurse is developing a plan of care for a client diagnosed with acute renal failure (ARF). Which statement would be an appropriate outcome for the client?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

What medication would the nurse prepare to give to reduce shivering in a hyperthermic client?

Correct Answer is D

Explanation

Which intervention does the nurse utilize post-operatively to assess the patency of the arteriovenous fistula?

Correct Answer is B

Explanation

What are the warning signs of hypovolemia?

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