The nurse is planning care for a client with chronic kidney disease who is a resident at a long-term nursing facility. The client is anuric and has hemodialysis 3 times a week. Which intervention should the nurse include in the client's plan of care?

Initiate toileting schedule.

Monitor for signs of anemia.

Encourage intake of high potassium foods.

Provide perineal skin barrier cream.

Answer and Explanation

The Correct Answer is B

A.   A toileting schedule is unnecessary for an anuric client as they do not produce urine.
B.   Anemia is a common complication of chronic kidney disease due to reduced erythropoietin production, so monitoring for signs of anemia is important.
C.   High potassium foods should be avoided as impaired kidney function can lead to hyperkalemia.
D.   While perineal skin care is important, it is not as critical as monitoring for anemia in this context.

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Correct Answer is D

Explanation

A: Osmolality measures the concentration of solutes in the blood and is not typically affected by naproxen or indicative of the reported symptoms.

B: While naproxen can cause gastrointestinal irritation and ulceration, it does not typically affect serum calcium levels. Monitoring serum calcium would not directly address the client's reported symptoms.

C: ESR is a nonspecific marker of inflammation and is not directly related to the reported symptoms of stomach pain, weakness, and fatigue associated with naproxen use.

D: Naproxen, a nonsteroidal anti-inflammatory drug (NSAID), can cause gastrointestinal bleeding, which may lead to anemia and a decrease in hemoglobin levels. Monitoring hemoglobin levels can help assess for gastrointestinal bleeding in this client who is experiencing stomach pain and weakness/fatigue.

A. Heart rate 121 beats/minute B. Capillary refill 2 seconds C. Respirations 28 breaths/minute with shallow breathing D. Radial and pedal pulses 2+ E. Severe abdominal pain in right lower quadrant F. Feels anxious G. Temperature 100.8° F (38.2° C) H. Vomiting small amounts of green bile I. Blood pressure 115/76 mm Hg

Correct Answer is ["A","C","E","G","H"]

Explanation

A. Tachycardia indicates the body is responding to pain, infection, or potential sepsis. It's a critical vital sign indicating the body's stress response.
B. Tachypnea can be a response to pain or anxiety but also indicates the need for careful monitoring of respiratory status, especially postoperatively.

C. A capillary refill of 2 seconds is within the normal range and indicates adequate peripheral perfusion.
D. Radial and pedal pulses 2+ are within the normal range and indicates adequate peripheral perfusion.
E. Severe abdominal pain in the right lower quadrant is a primary symptom of appendicitis, which is confirmed by the CT scan showing a dilated appendix and fat stranding. Immediate attention is needed to address potential complications such as rupture.
F. Feeling anxious needs to be managed to promote patient comfort. However, it doesn’t need to be managed immediately since it is not life-threatening.
G. Fever is a sign of infection or inflammation, common in appendicitis. Monitoring and managing fever is crucial in preventing further complications.
H. Bilious vomitus is a common finding in appendicitis and may indicate that the inflammation has progressed to a point where it is causing a blockage in the intestines. This obstruction can lead to increased pressure within the abdominal cavity and compromise blood flow, potentially resulting in a life-threatening situation.
I. A blood pressure of 115/76 mm Hg is within normal limits and indicates stable hemodynamics at this point.

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The nurse is planning care for a client with chronic kidney disease who is a resident at a long-term nursing facility. The client is anuric and has hemodialysis 3 times a week. Which intervention should the nurse include in the client's plan of care?

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Naxlex Comprehensive Predictor Exams

A client with arthritis has been receiving treatment with naproxen and now reports ongoing stomach pain, increasing weakness, and fatigue. Which laboratory test should the nurse monitor?

Correct Answer is D

Explanation

Exhibits The nurse is caring for the client. Which of the following assessment findings should the nurse prioritize?

Correct Answer is ["A","C","E","G","H"]

Explanation

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