A nurse is caring for a client experiencing kidney failure. The nurse recognizes that kidney failure causes the loss of which of the following processes integral to maintaining homeostasis?
Distribution of protein
Filtration of the blood
Metabolism of medications
Ability to hold urine
The Correct Answer is B
A. Distribution of protein: While protein distribution may be affected in kidney disease, it is not a primary function of the kidneys.
B. Filtration of the blood: The kidneys are responsible for filtering waste products and excess substances from the blood. In kidney failure, this filtration process is impaired, leading to the accumulation of toxins in the body.
C. Metabolism of medications: Although the kidneys do play a role in drug excretion, drug metabolism primarily occurs in the liver. Kidney failure may affect the excretion phase.
D. Ability to hold urine: While kidney failure can affect urinary function, the ability to hold urine is primarily a bladder function, not directly a function of the kidneys.
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Correct Answer is D
Explanation
A. "Gradually decrease the dose once tolerance to the effect is reached." Tolerance can develop over time, but this approach is not the most effective or safest way to manage sedation.
B. "Take the medication with meals." Taking diphenhydramine with food may help with gastrointestinal side effects but does not reduce sedation.
C. "Distribute the doses evenly throughout the day." Distributing doses evenly may not effectively reduce sedation, as diphenhydramine has sedative effects regardless of timing.
D. "Take the daily dose at bedtime.” Taking diphenhydramine at bedtime can minimize daytime sedation, as the sedative effects will occur during sleep.
Correct Answer is ["A","C","D"]
Explanation
A. Perform passive range of motion exercises. Passive range of motion exercises help maintain circulation and reduce venous stasis, which is crucial for preventing pulmonary embolism in clients who are immobile.
B. Place pillows under the client's knees when in bed. Placing pillows under the knees can actually promote venous stasis and increase the risk of a pulmonary embolism. It is better to keep the legs flat to encourage circulation.
C. Assess legs for redness. Regular assessment of the legs for redness, swelling, or warmth helps in the early detection of deep vein thrombosis (DVT), which can lead to pulmonary embolism if not addressed.
D. Apply elastic compression stockings. Elastic compression stockings promote venous return from the legs to the heart and help prevent DVT, thereby reducing the risk of pulmonary embolism.
E. Massage the calves every shift. Massaging the calves can dislodge a thrombus and potentially lead to a pulmonary embolism. Instead, interventions should focus on preventing thrombus formation.