A patient's serum creatinine level is increasing but the urine creatinine clearance is decreasing. These assessment findings would indicate which of the following to the nurse?
1. malnutrition
2. decreased glomerular functioning
3. onset of heart failure
4. associated hypokalemia
2
Rationale: Creatinine is the end-product of muscle metabolism and is released into the blood at a constant rate. Creatinine is larger in size compared to urea and is not reabsorbed back into the blood, but is eliminated at a rate related to the level of renal function. For this reason, it is a more reliable measure of the state of renal health. A decrease in the urinary creatinine clearance rate indicates a decrease in glomerular function. A rise in serum creatinine level also indicates a decrease in glomerular functioning. These two laboratory values are not indicated to determine malnutrition, the onset of heart failure, or associated hypokalemia.
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The nurse is caring for a patient with a diagnosis of vulvar cancer who has returned from the PACU after undergoing a wide excision of the vulva. How should this patient's analgesic regimen be best managed?
A) Analgesia should be withheld unless the patient's pain becomes unbearable. B) Scheduled analgesia should be administered around-the-clock to prevent pain. C) All analgesics should be given on a PRN, rather than scheduled, basis. D) Opioid analgesics should be avoided and NSAIDs exclusively provided.
The mother of a 1-year-old client has placed the child on a low-fat diet to prevent the development of obesity. What should the nurse explain to this mother?
a. It is never too early to worry about childhood obesity b. Children should be switched to a low-fat diet when they reach their first birthday c. Fat is an extremely important component in the diet of children under the age of two d. Studies have shown that children who are not on a low-fat diet often develop coronary disease as adults
When questioning the participants of your in-service program on the disadvantages of working in groups, which response by participants would indicate that further teaching is needed? "Some of the disadvantages of working in groups include: a. the fact that working in groups can be time consuming and it can foster dependency.". b. a potential for personality conflicts and for individual
opinions to be influenced byothers.". c. promotion of ownership of problems and solutions.". d. inequity of time to share individual information and dependency may be fostered.".
The client is taking medication to promote defecation. Which of the following instructions should the nurse include in the teaching plan for this client?
a. Increased laxative use often causes hyperkalemia. b. Salt tablets should be taken to increase the solute concentration of the extracellu-lar fluid. c. Emollient laxatives may increase the amount of water secreted into the bowel. d. Bulk-forming additives may turn the urine pink.