What nursing assessment finding would suggest inadequate renal perfusion in a patient being stabilized after an acute coronary syndrome (myocardial infarction)?
Low urine osmolarity and creatinine clearance.
Decreasing serum blood urea nitrogen (BUN) level.
Urine output of less than 30 mL/hr.
Urine specific gravity of less than 1.010.
The Correct Answer is C
Choice A rationale
Low urine osmolarity and creatinine clearance are not the primary indicators of inadequate renal perfusion in a patient being stabilized after an acute coronary syndrome. These measures reflect the concentration of the urine and the kidney’s ability to filter waste from the blood, respectively. While they can be affected by renal perfusion, they are not the most direct or reliable indicators.
Choice B rationale
A decreasing serum blood urea nitrogen (BUN) level is not typically associated with inadequate renal perfusion. In fact, a high BUN level may indicate that the kidneys aren’t working properly. However, BUN levels can be influenced by many factors, including protein intake and liver function, so they are not the most reliable indicator of renal perfusion.
Choice C rationale
A urine output of less than 30 mL/hr is a common sign of inadequate renal perfusion. The kidneys need adequate blood flow to filter waste products from the blood and produce urine. If renal perfusion is inadequate, urine output can decrease.
Choice D rationale
A urine-specific gravity of less than 1.010 is not typically associated with inadequate renal perfusion. Specific gravity is a measure of the concentration of solutes in the urine. It can be influenced by hydration status and certain kidney disorders, but it is not a direct measure of renal perfusion.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Chronic stable angina, also known as angina pectoris, is a type of chest pain that occurs when the heart muscle doesn’t get enough oxygen. It is often triggered by physical activity or emotional stress and is usually relieved by rest or medication such as nitroglycerin. Therefore, a patient statement that the pain goes away after taking a nitroglycerin tablet would help confirm a previous diagnosis of chronic stable angina.
Correct Answer is C
Explanation
Choice A rationale
Diltiazem does not increase the contractile force of the heart. In fact, it is classified as a negative inotrope, meaning it decreases the force of heart contractions.
Choice B rationale
While diltiazem can affect heart rhythm, it does not specifically reduce heart palpitations. Its primary effect is to slow the heart rate and relax the blood vessels.
Choice C rationale
Diltiazem is a calcium channel blocker used to manage cardiovascular conditions such as hypertension, chronic stable angina, atrial fibrillation, and Prinzmetal’s angina. It works by inhibiting the calcium influx into cardiac and vascular smooth muscle during depolarization. This results in vasodilation, or the widening of blood vessels, which can help decrease coronary artery spasms, a characteristic feature of Prinzmetal’s angina.
Choice D rationale
Diltiazem does not prevent the formation of plaque in the coronary arteries. It primarily acts to relax the blood vessels and slow the heart rate.
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