When providing preoperative care for a client with an abdominal aneurysm, changes in which assessment finding are most important for the practical nurse (PN) to report to the registered nurse (RN)?

Choice A reason: Measuring intake and output while straining all urine is the priority action. This helps to monitor kidney function, assess fluid balance, and detect the passage of kidney stones. Straining urine can also catch any stones or fragments, which can be analyzed to determine their composition and guide further treatment.
Choice B reason: Reviewing foods that are high in oxalate is important for dietary management of kidney stones, but it is not the immediate priority. Dietary education is more relevant once the client's acute symptoms are managed and stabilized.
Choice C reason: Monitoring the client's serum calcium levels is important in the management of certain types of kidney stones, particularly those formed from calcium. However, this action is not as immediate a priority as measuring intake and output and straining urine to assess for stone passage.
Choice D reason: Encouraging the client to begin a weight loss program is beneficial for overall health and can reduce the risk of future kidney stones. However, it is not the immediate priority when treating an acute episode of kidney stones.

Choice A reason: Aldosterone is a hormone produced by the adrenal cortex that helps regulate sodium and potassium levels in the body. While aldosterone levels can indicate adrenal function, they are not as commonly used as cortisol levels in diagnosing adrenal cortex failure. Aldosterone regulation is also influenced by the renin-angiotensin-aldosterone system, making it a less direct indicator of overall adrenal cortex function compared to cortisol.
Choice B reason: Cortisol is a glucocorticoid hormone produced by the adrenal cortex and plays a vital role in regulating metabolism, immune response, and stress. Measuring cortisol levels is a primary method for assessing adrenal cortex function. Low cortisol levels can indicate adrenal insufficiency or failure, such as in conditions like Addison's disease. Evaluating cortisol levels provides a direct assessment of the adrenal gland’s ability to produce essential hormones necessary for the body's normal functioning.
Choice C reason: Thyroxine (T4) is a hormone produced by the thyroid gland, not the adrenal cortex. It plays a crucial role in regulating metabolism, growth, and development. While thyroxine levels are important for thyroid function assessment, they do not directly reflect the functioning of the adrenal gland. Therefore, thyroxine levels are not relevant in diagnosing adrenal cortex failure.
Choice D reason: Insulin is a hormone produced by the pancreas and is essential for regulating blood glucose levels. It is not related to the adrenal cortex. Monitoring insulin levels is important for diagnosing and managing diabetes mellitus but does not provide information about the functioning of the adrenal gland. Insulin levels are not used to assess adrenal cortex function.