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A client who has developed acute kidney injury (AKI) due to an aminoglycoside antibiotic has moved from the oliguric phase to the diuretic phase of AKI. Which parameters are most important for the nurse to plan to carefully monitor?

A.

Elevated creatinine and blood urea nitrogen (BUN).

B.

Hypovolemia and electrocardiographic (ECG) changes.

C.

Uremic irritation of mucous membranes and skin surfaces.

D.

Side effects of total parenteral nutrition (TPN) and intralipids.

Answer and Explanation

The Correct Answer is B

A. While elevated creatinine and BUN are important indicators of kidney function, in the diuretic phase, the focus shifts to monitoring for complications, particularly fluid and electrolyte balance.  

 

B. Hypovolemia can occur due to excessive diuresis during the diuretic phase, which can lead to significant cardiovascular effects, including ECG changes related to electrolyte imbalances, particularly potassium levels.  

 

C. Monitoring for uremic irritation is important but less critical than monitoring for hypovolemia and ECG changes that can lead to acute complications.  

 

D. While monitoring for side effects of TPN is relevant, it is not the priority in the context of AKI transitioning phases where fluid and electrolyte balance are paramount.  


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View Related questions

Correct Answer is B

Explanation

A. restatement. Restatement involves repeating the patient’s words exactly, while here, the nurse is rephrasing the sentiment.

B. reflection. Reflection focuses on the patient’s feelings or experiences by paraphrasing their statement, helping the patient explore their feelings, which the nurse is doing here.

C. open-ended question. An open-ended question would be broad, allowing the patient to provide more information. This response is a restatement, not a question.

D. offering self. Offering self involves expressing a willingness to stay or support the patient, which is not demonstrated here.

Correct Answer is D

Explanation

A. Visible swelling of the neck may indicate other conditions, such as thyroid issues, but it is not a characteristic finding of Cushing's syndrome.

B. Warm, soft, moist, salmon-colored skin is more indicative of hyperthyroidism rather than Cushing's syndrome, which typically presents with thin, fragile skin.

C. A husky voice and hoarseness can occur due to various reasons, but they are not classic symptoms of Cushing's syndrome.

D. Central type obesity, characterized by a rounded face and thin extremities, is a hallmark feature of Cushing's syndrome, caused by excessive cortisol levels leading to fat redistribution.

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