Your patient with kidney stones develops acute kidney injury and hydronephrosis. What is the best treatment for this postrenal kidney injury?
remove offending medication
correct hypovolemia with IV fluids
remove obstruction
ask about medication history
The Correct Answer is C
A. Remove offending medication is incorrect because this approach applies to intrarenal causes of AKI, such as nephrotoxic medications like NSAIDs, aminoglycosides, or contrast dyes. While stopping these drugs can prevent further kidney damage, it does not address the actual cause of postrenal AKI, which is a mechanical blockage in the urinary tract.
B. Correct hypovolemia with IV fluids is incorrect because this intervention targets prerenal AKI, where reduced kidney perfusion due to dehydration, blood loss, or hypotension is the issue. In postrenal AKI, the problem is urine flow obstruction, not perfusion. Administering fluids alone will not restore kidney function and may even worsen complications if hydronephrosis is present.
C. Remove obstruction is correct because postrenal AKI occurs when urine cannot exit the kidneys due to a blockage, leading to back pressure, hydronephrosis, and impaired filtration. In this case, kidney stones are the obstructing factor. Effective management requires rapid relief of the obstruction through interventions such as stone removal, ureteral stenting, catheterization, or surgery, depending on the location and size of the obstruction. Relieving the obstruction restores urine flow, reduces pressure on the kidneys, prevents permanent damage, and decreases the risk of infection or electrolyte imbalances.
D. Ask about medication history is incorrect because although understanding a patient’s medication use is important for overall kidney health and identifying nephrotoxic drugs, it does not treat the obstruction causing postrenal AKI. This step is supportive rather than curative in this acute scenario.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Skull fracture is correct because bruising behind the ears (Battle’s sign) and around the eyes (raccoon eyes) are classic indicators of a basal skull fracture. These bruises result from bleeding from the fracture site tracking into surrounding soft tissues. Basal skull fractures carry significant risks, including cerebrospinal fluid (CSF) leak, intracranial hemorrhage, and cranial nerve injury, and require urgent assessment and monitoring.
B. Mastoiditis is incorrect because this is an infection of the mastoid bone, usually secondary to untreated middle ear infections. While bruising is near the mastoid area, mastoiditis does not cause Battle’s signafter trauma.
C. Subdural hematoma is incorrect because although head trauma can cause subdural hematomas, the presence of periorbital and postauricular bruising specifically indicates a skull fracture, not a hematoma itself. Subdural hematomas require imaging for diagnosis and may accompany a skull fracture but are not diagnosed by bruising patterns alone.
D. Concussion is incorrect because a concussion is a functional brain injury without structural damage. While it can occur with head trauma, raccoon eyes and Battle’s sign are not typical of concussion; they indicate structural skull damage.
Correct Answer is ["A","C","D"]
Explanation
A. Kussmaul’s respirations are correct because DKA causes metabolic acidosis due to the accumulation of ketone bodies. The body compensates by increasing the depth and rate of respirations to blow off carbon dioxide, resulting in deep, rapid breathing known as Kussmaul respirations.
B. Dysuria is incorrect because painful or difficult urination is not a characteristic symptom of DKA. While patients may have polyuria due to osmotic diuresis from hyperglycemia, dysuria is more suggestive of a urinary tract infection.
C. “Fruity” breath is correct because acetone, a byproduct of ketone metabolism, is exhaled through the lungs. This gives the breath a sweet or fruity odor and is a classic finding in patients with DKA.
D. Ketonuria is correct because insulin deficiency leads to fat breakdown and ketone production. Excess ketones are excreted in the urine, making ketonuria a key diagnostic and expected finding in DKA.
E. Glucose levels below 100 are incorrect because DKA is characterized by significant hyperglycemia, typically with blood glucose levels well above normal, often greater than 250 mg/dL.
Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.
Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today
Report Wrong Answer on the Current Question
Do you disagree with the answer? If yes, what is your expected answer? Explain.
Kindly be descriptive with the issue you are facing.