You have a patient with Acute Kidney injury. You monitor the patient for: (Select all that apply, may be one or more)
Hypernatremia
ECG changes
Hypotension
Pulmonary edema
Urine with high specific gravity
Correct Answer : B,D
A. Hypernatremia: Sodium levels are usually normal or low in AKI because impaired kidney function often causes fluid retention and dilutional hyponatremia. Hypernatremia is less common unless influenced by external sodium administration.
B. ECG changes: Electrolyte imbalances, particularly hyperkalemia, can lead to ECG abnormalities such as peaked T waves, widened QRS complexes, or arrhythmias. Continuous cardiac monitoring is essential for patient safety.
C. Hypotension: While hypotension can cause AKI (prerenal), once the patient has AKI, they are more likely to experience Hypertension due to fluid volume overload and the activation of the renin-angiotensin-aldosterone system.
D. Pulmonary edema: Volume overload can lead to pulmonary congestion, crackles, and respiratory distress. Monitoring respiratory status and oxygen saturation is critical to detect and manage this complication.
E. Urine with high specific gravity: In intrarenal AKI (Acute Tubular Necrosis), the kidneys lose their ability to concentrate urine. The specific gravity becomes "fixed" at around 1.010, which is the same as the osmolality of plasma.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","C","E"]
Explanation
A. Normal ICP 0-15 mmHg: Normal intracranial pressure in adults ranges from 0 to 15 mm Hg. Values above this range indicate increased ICP and may compromise cerebral perfusion.
B. None: This option does not provide relevant information regarding the Monroe-Kellie hypothesis or ICP.
C. If the volume and pressure of one component increases, the volume and the pressure of the other 2 components must decrease if pressure is to remain normal; compensation is a function of compliance: The Monroe-Kellie hypothesis states that the cranial vault is a fixed space containing brain tissue, blood, and cerebrospinal fluid (CSF). An increase in one component requires a compensatory decrease in others to maintain normal ICP.
D. None: This option does not provide relevant information regarding ICP or the Monroe-Kellie hypothesis.
E. Ptissue + Pblood + PCSF = ICP (80%/10%/10%): The total ICP is the sum of the pressures contributed by brain tissue (~80%), blood (~10%), and CSF (~10%). This relationship reflects the distribution of intracranial components under normal conditions.
Correct Answer is C
Explanation
A. Increased protein diet: Increasing protein intake can raise ammonia levels because protein metabolism produces nitrogenous waste. In cirrhosis, impaired hepatic detoxification limits conversion of ammonia to urea. Excess protein may worsen hepatic encephalopathy symptoms.
B. Decreased sodium diet: Sodium restriction is commonly used to manage ascites and edema in cirrhosis. While important for fluid balance, it does not directly reduce ammonia production or levels. This intervention addresses volume status rather than encephalopathy risk.
C. Decreased protein diet: Reducing dietary protein lowers ammonia generation from intestinal breakdown of amino acids. This approach helps decrease neurotoxic ammonia accumulation when hepatic clearance is compromised. Protein intake is often temporarily restricted during episodes of elevated ammonia.
D. Increased carbohydrate diet: Carbohydrates provide an alternative energy source and can help prevent protein catabolism. While beneficial as part of overall nutrition, increasing carbohydrates alone does not directly reduce ammonia production. It is supportive rather than primary management for hyperammonemia.
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