A patient has acute kidney injury (previously known as acute tubular necrosis). The following blood work was noted: complete blood count shows a white blood cell count of 11,000 mm3, a hemoglobin of 8 g/dL, and a hematocrit of 30%
His chemistry panel shows serum potassium, 4.5 mg/dL; serum sodium, 135 mg/dL; serum calcium, 8.5 mg/dL; BUN, 20 mg/dL; and creatinine, 1.5 mg/dL. What laboratory value(s) need(s) to be treated most immediately and why?
a. Administration of 5% dextrose in water and insulin because the patient is hyperkalemic and needs this level reduced
b. Administration of Epogen to treat anemia
c. Administration of a broad-spectrum antibiotic to treat the elevated blood cell count
d. Administration of a calcium supplement for low calcium
B
A patient showing signs of anemia per his hematocrit and hemoglobin must be treated. Epogen is used because it helps stimulate erythrocyte production by the bone marrow.
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A 12-year-old pediatric client is in need of surgery. The health care member who is legally responsible for obtaining informed consent for an invasive procedure is the:
1. Nurse. 2. Social worker. 3. Unit secretary. 4. Physician.
A nurse assesses an edematous cardiac patient. The nurse is aware that this condition is a result of retained fluid. What is the patient considered to be?
a. Hyponatremic b. Hypokalemic c. Hypernatremic d. Hypercalcemic
In instructing the patient in the use of vaginal weight training, the nurse coaches the patient to insert the smallest of the cones in the vagina and:
a. wear it all day. b. perform 10 Kegel exercises and remove it, repeating this exercise three times a day. c. hold it in place with muscle tightening for 15 minutes and remove it. d. attempt to expel it with vaginal muscle tightening.
Lina is an 18-year-old woman at 20 weeks' gestation. This is her first pregnancy. Lina is complaining of fatigue and listlessness
Her vital signs are within a normal range: BP = 118/60, pulse = 70, and respiratory rate 16 breaths per minute. Lina's fundal height is at the umbilicus, and she states that she is beginning to feel fetal movements. Her weight gain is 25 pounds over the prepregnant weight (110 lb), and her height is 5 feet 4 inches. The perinatal nurse's best approach to care at this visit is to: a. Ask Lina to keep a 3-day food diary to bring in to her next visit in 1 week. b. Explain to Lina that weight gain is not a concern in pregnancy, and she should not worry. c. Teach Lina about the expected normal weight gain during pregnancy (approximately 20 pounds by 20 weeks' gestation). d. Explain to Lina the possible concerns related to excessive weight gain in pregnancy, including the risk of gestational diabetes.