A nurse is preparing a client for a kidney biopsy. Which of the following client conditions should the nurse identify as a contraindication for this diagnostic test?
Flank pain
Elevated creatinine level
Coagulation disorder
Urinary retention
The Correct Answer is C
Rationale:
A. Flank pain alone is not a contraindication for a kidney biopsy, although it may be a symptom that necessitates the biopsy to determine the cause of kidney issues.
B. An elevated creatinine level indicates impaired kidney function but is not a contraindication for a kidney biopsy; in fact, it may be a reason to perform the biopsy.
C. A coagulation disorder is a contraindication for a kidney biopsy because it increases the risk of bleeding during and after the procedure. It is crucial to ensure that coagulation parameters are within a safe range before performing this invasive test.
D. Urinary retention does not contraindicate a kidney biopsy, although it may need to be addressed separately.
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Correct Answer is C
Explanation
Rationale:
A. Hypernatremia, an elevated sodium level, does not cause Trousseau's or Chvostek's signs.
B. Hypermagnesemia, an elevated magnesium level, is not associated with positive Trousseau's and Chvostek's signs.
C. Hypocalcemia, a low calcium level, is commonly associated with positive Trousseau's and Chvostek's signs. Trousseau's sign is a carpopedal spasm induced by inflating a blood pressure cuff, while Chvostek's sign is facial twitching in response to tapping over the facial nerve. Both are indicative of neuromuscular irritability due to low calcium levels.
D. Hypokalemia, a low potassium level, does not cause these specific signs and is associated with different clinical manifestations.
Correct Answer is D
Explanation
Rationale:
A. Children with Addison’s disease often require increased sodium intake, especially during periods of stress or illness, due to the lack of aldosterone.
B. Addison's disease typically causes fluid volume deficit rather than excess.
C. Addison's disease is more commonly associated with hypoglycemia rather than hyperglycemia.
D. Teaching the parents about cortisol replacement therapy is crucial, as this is the primary treatment for managing Addison’s disease. The child will need lifelong hormone replacement to compensate for the lack of cortisol.