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. Hemoglobin A1C reflects average blood glucose levels over the past 2 to 3 months, not just after meals, so this statement is not fully accurate.
B. A high A1C indicates chronically high blood glucose levels, not low blood sugar levels, so this statement would be misleading.
C. An A1C of 9% indicates that the client's average blood sugar has been high over the past few months, which increases the risk of diabetes-related complications.
D. While a high A1C may suggest variability in blood glucose levels, the more accurate statement is that the average blood glucose is high, which is what the A1C primarily reflects
Correct Answer is A
Explanation
Rationale:
A. A rapid weight gain, such as a 5 lb increase in one day, is a strong indicator of fluid overload, particularly in clients with end-stage kidney disease. This excess fluid retention can lead to complications like pulmonary edema and congestive heart failure.
B. An oxygen saturation of 93% is slightly low but not a direct indicator of fluid overload; it may be related to other factors like anemia or underlying lung disease.
C. Normal skin turgor, where the skin returns to its previous position after being pinched, does not indicate fluid overload. In fluid overload, you might see pitting edema, where the skin does not return immediately.
D. Flattened neck veins would suggest a lack of fluid, not an overload. In fluid overload, you would expect to see distended neck veins (jugular venous distension).