Which finding in the patient's history increases the risk for acute pancreatitis?

Choice A rationale

An increasing hemoglobin level does not indicate the resolution of acute pancreatitis. Hemoglobin levels can fluctuate due to various factors, including hydration status and blood loss, but are not directly related to the resolution of pancreatitis.

Choice B rationale

During an episode of acute pancreatitis, serum concentrations of amylase and lipase rise significantly, often within hours of pancreatic injury. These elevated enzyme levels are key components in diagnosing the condition. As the inflammation subsides and the pancreas begins to heal, the levels of these enzymes typically decrease, returning to normal ranges. Therefore, a declining serum amylase level suggests that the acute inflammatory process is resolving.

Choice C rationale

Serum bilirubin levels are indicative of liver function and bile metabolism. Elevated bilirubin may occur if pancreatitis leads to bile duct obstruction or liver involvement. However, a decrease in bilirubin levels addresses biliary system recovery rather than directly reflecting pancreatic inflammation resolution.

Choice D rationale

An increasing serum alkaline phosphatase level is generally associated with bile duct obstruction or bone disease and does not indicate the resolution of acute pancreatitis. This enzyme is found in several tissues throughout the body, including the liver and bones.

Choice A rationale
The red blood cell (RBC) count is not typically affected by hemodialysis. Hemodialysis is a process that primarily targets the removal of waste products and excess fluid from the blood, not red blood cells.

Choice B rationale
Potassium levels are often elevated in clients with renal failure due to the kidneys' inability to excrete potassium. Hemodialysis helps to remove excess potassium from the bloodstream, thereby decreasing its levels.

Choice C rationale
Calcium levels can be affected by hemodialysis; however, they are more often managed with medication and diet rather than being directly targeted by the dialysis process itself.

Choice D rationale
Protein levels should not decrease significantly as a result of hemodialysis. The dialysis membrane is designed to allow small waste products to pass through while retaining larger molecules like proteins.