The practical nurse (PN) identifies an electrolyte imbalance, a generalized edema, and a weight gain of 4.4 lbs (2 kg) in 24 hours for a client with chronic kidney disease. Which intervention in the plan of care should the PN implement?
Encourage a low carbohydrate diet.
Use a cushion when sitting.
Perform range of motion exercises.
Discuss a low sodium diet.
The Correct Answer is D
A. Encourage a low carbohydrate diet: Carbohydrate restriction does not address fluid retention, edema, or electrolyte imbalances associated with chronic kidney disease and is not the priority intervention in this scenario.
B. Use a cushion when sitting: This intervention may help prevent skin breakdown, but it does not address the underlying fluid overload or electrolyte imbalance.
C. Perform range of motion exercises: ROM exercises support joint mobility and circulation, but they do not directly manage fluid retention or prevent further complications from electrolyte disturbances.
D. Discuss a low sodium diet: Sodium restriction helps manage fluid retention, edema, and blood pressure in clients with chronic kidney disease. Implementing a low-sodium diet directly targets the cause of weight gain and generalized edema, making it the priority intervention.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. Increase the oxygen delivery by 10%: While hypoxemia is present, simply increasing oxygen may be insufficient for a client who is difficult to arouse and in severe respiratory distress. Immediate advanced airway intervention is a higher priority.
B. Administer PRN nebulizer treatment: Bronchodilators can improve airway obstruction but will not rapidly correct profound hypoxemia or altered mental status in a critically decompensating client. This intervention alone is not adequate.
C. Complete neurological assessment: Assessing neurological status is important, but the client’s low oxygen saturation and decreased responsiveness indicate a life-threatening situation that requires immediate intervention before completing a full assessment.
D. Prepare for rapid sequence intubation: The client exhibits severe hypoxemia, high respiratory rate, and decreased level of consciousness—signs of impending respiratory failure. Rapid sequence intubation ensures airway protection and adequate ventilation, which is the priority action to prevent respiratory arrest.
Correct Answer is C
Explanation
A. Request that a respiratory therapist come to the room: While a respiratory therapist can assist, the immediate need is to ensure the client receives oxygen. Delaying to call for help does not address the urgent requirement for oxygen delivery.
B. Secure the straps around each of the client's ears: Straps should be secured after properly positioning the mask. Securing straps first may result in improper fit and ineffective oxygen delivery.
C. Place mask over the bridge of the nose and then the mouth: Correct placement of the mask over the nose and mouth is the first priority to ensure an adequate oxygen seal and effective therapy. Proper positioning allows oxygen to be delivered safely before checking other components.
D. Check that the reservoir bag inflates during exhalation: Observing the reservoir bag is important to verify oxygen flow, but it cannot be done effectively until the mask is correctly positioned on the client’s face.
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