Which laboratory results should the nurse closely monitor in a client who has end-stage renal disease (ESRD)?

Blood pressure, heart rate, and temperature.

Leukocytes, neutrophils, and thyroxine.

Serum potassium, calcium, and phosphorus.

Erythrocytes, hemoglobin, and hematocrit.

Answer and Explanation

The Correct Answer is C

Choice C reason: serum potassium, calcium, and phosphorus are electrolytes that can be affected by ESRD. ESRD is a condition in which the kidneys lose their ability to filter waste products and excess fluids from the blood. This can cause electrolyte imbalances that can lead to serious complications, such as cardiac arrhythmias, bone disorders, or metabolic acidosis. The nurse should closely monitor these electrolytes and report any abnormal values.

Choice A reason: blood pressure, heart rate, and temperature are vital signs that are not specific to ESRD. Vital signs can be influenced by many factors and may not reflect the severity of kidney damage. The nurse should monitor vital signs regularly, but not as closely as electrolytes.

Choice B reason: leukocytes, neutrophils, and thyroxine are not laboratory results that are directly related to ESRD. Leukocytes and neutrophils are types of white blood cells that are involved in immune response and inflammation. Thyroxine is a hormone that regulates metabolism and growth. These laboratory results may be altered by other conditions or medications, but not by ESRD.

Choice D reason: erythrocytes, hemoglobin, and hematocrit are laboratory results that measure the red blood cell count and oxygen-carrying capacity of the blood. These laboratory results may be decreased in ESRD due to anemia, which is a common complication of chronic kidney disease. However, anemia is not as life-threatening as electrolyte imbalances and can be treated with erythropoietin injections or iron supplements.

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Correct Answer is ["B","C","D","E"]

Explanation

Choice B reason: monitoring abdominal girth is an important intervention for a client with cirrhosis of the liver and end stage liver disease. Cirrhosis of the liver can cause portal hypertension, which is an increased pressure in the portal vein that carries blood from the digestive organs to the liver. Portal hypertension can lead to ascites, which is an accumulation of fluid in the abdominal cavity. The nurse should measure and record the abdominal girth daily and report any significant changes.

Choice C reason: reporting serum albumin and globulin levels is an important intervention for a client with cirrhosis of the liver and end stage liver disease. Cirrhosis of the liver can impair the synthesis of proteins, such as albumin and globulin, which are essential for maintaining fluid balance, immune function, and blood clotting. The nurse should monitor and report the serum albumin and globulin levels and administer supplements or transfusions as prescribed.

Choice D reason: noting signs of bleeding and edema is an important intervention for a client with cirrhosis of the liver and end stage liver disease. Cirrhosis of the liver can cause coagulopathy, which is a disorder of blood clotting, due to reduced production of clotting factors and increased consumption of platelets. Coagulopathy can lead to bleeding from various sites, such as the gums, nose, esophagus, stomach, or rectum. The nurse should observe and report any signs of bleeding and apply pressure or bandages as needed. Cirrhosis of the liver can also cause hypoalbuminemia, which is a low level of albumin in the blood, due to decreased synthesis or increased loss of albumin. Hypoalbuminemia can lead to edema, which is swelling caused by fluid retention in the tissues. The nurse should assess and report any signs of edema and elevate the affected limbs or apply compression stockings as indicated.

Choice E reason: limiting fluid intake to 1500 mL daily is an important intervention for a client with cirrhosis of the liver and end stage liver disease. Fluid restriction can help prevent or reduce ascites and edema by decreasing the fluid load on the circulatory system and the kidneys. The nurse should measure and record the fluid intake and output and educate the client on how to limit their fluid intake.

Choice A reason: providing a diet low in phosphorus is not a specific intervention for a client with cirrhosis of the liver and end stage liver disease. A diet low in phosphorus may be indicated for clients with chronic kidney disease or hyperphosphatemia, but not for clients with cirrhosis of the liver. The nurse should provide a diet that is high in calories, carbohydrates, and protein, but low in sodium, fat, and alcohol for clients with cirrhosis of the liver.

A. 18%. B. 45%. C. 9%. D. 36%.

Correct Answer is C

Explanation

Choice A reason: This is incorrect because 18% is the percentage of body surface area for the entire anterior trunk, not just the lower extremities.

Choice B reason: This is incorrect because 45% is the percentage of body surface area for the entire anterior and posterior trunk, plus the head and neck, not just the lower extremities.

Choice C reason: This is correct because 9% is the percentage of body surface area for the anterior surfaces of both lower extremities, according to the rule of nines.

Choice D reason: This is incorrect because 36% is the percentage of body surface area for the entire anterior and posterior surfaces of both lower extremities, not just the anterior surfaces.

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Which laboratory results should the nurse closely monitor in a client who has end-stage renal disease (ESRD)?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client with cirrhosis of the liver is admitted with complications related to end stage liver disease. Which intervention(s) should the nurse implement? (Select all that apply.)

Correct Answer is ["B","C","D","E"]

Explanation

Correct Answer is C

Explanation

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