Which condition causes the formation of biliary sludge?

Choice A reason: Spironolactone is a potassium-sparing diuretic, so it is more likely to cause elevated potassium levels rather than decreased levels.
Choice B reason: Chloride levels are not typically affected in a predictable pattern with the use of spironolactone or in liver failure with ascites.
Choice C reason: Phosphate levels are not commonly altered by spironolactone or in ascites, and any changes would depend on other metabolic factors.
Choice D reason: Spironolactone can lead to decreased sodium levels due to its action as a diuretic that promotes sodium excretion while retaining potassium. This is particularly relevant in clients with liver failure and ascites, where fluid and electrolyte management is crucial.

Choice A reason: Cleaning the inside of the container with a wipe is not a part of the standard procedure for collecting a midstream urine sample. The focus should be on maintaining external cleanliness to avoid contamination of the sample, rather than cleaning the container itself.
Choice B reason: Urinating a little then stopping, while part of the process, is not enough information to indicate a complete understanding of the procedure. The more critical aspect is how the client cleans and collects the sample to ensure it is not contaminated.
Choice C reason: Using the cleansing wipe from front to back is the correct procedure for collecting a midstream urine sample. This method helps prevent contamination from bacteria that could be present around the genital area, ensuring a more accurate sample for analysis.
Choice D reason: Using each cleansing wipe twice is not advised. It can lead to contamination as the same wipe might transfer bacteria instead of eliminating them. It is essential to use a new wipe for each part of the cleaning process to maintain hygiene and ensure the accuracy of the urine sample.