A nurse is reviewing the BUN and creatinine levels of an older adult patient with chronic kidney disease. The nurse should anticipate which of the following findings?
BUN 8 mg/dL and creatinine 0.7 mg/dL
BUN 45 mg/dL and creatinine 8 mg/dL
BUN 23 mg/dL and creatinine 1.0 mg/dL
BUN 10 mg/dL and creatinine 0.3 mg/dL
The Correct Answer is B
Choice A reason:
A BUN level of 8 mg/dL and a creatinine level of 0.7 mg/dL are within normal ranges for a healthy individual without kidney disease. In chronic kidney disease (CKD), we would expect these values to be elevated due to the kidneys' reduced ability to filter waste products from the blood.
Choice B reason:
A BUN level of 45 mg/dL and a creatinine level of 8 mg/dL are significantly higher than the normal range, which is consistent with impaired kidney function seen in CKD. These elevated levels indicate that the kidneys are not effectively filtering urea and creatinine from the blood, leading to their accumulation.
Choice C reason:
A BUN level of 23 mg/dL and a creatinine level of 1.0 mg/dL could be seen in the early stages of CKD. While the creatinine level is within the normal range, the BUN level is slightly elevated, which may suggest a decline in kidney function.
Choice D reason:
A BUN level of 10 mg/dL and a creatinine level of 0.3 mg/dL are both below the normal range. This is an unlikely finding for a patient with CKD, as kidney impairment typically leads to increased levels of these substances in the blood.
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Correct Answer is C
Explanation
Choice A reason:
Skin traction is indeed less restrictive than skeletal traction, allowing for more mobility. It is applied using bandages or adhesive material to the skin, which can be removed or adjusted more easily than the pins or screws used in skeletal traction. This type of traction is typically used for short-term treatment before surgery or when the injury is less severe.
Choice B reason:
Discomfort levels can vary depending on the individual and the specific circumstances of the traction. However, skin traction is generally considered to be less painful than skeletal traction because it is less invasive and applies less force. Skeletal traction, which involves the insertion of pins or wires directly into the bone, is likely to cause more discomfort due to the invasive nature of the procedure.
Choice C reason:
Skeletal traction is more appropriate for reducing fractures, especially in cases where a greater force is needed to align the bones. It involves the surgical insertion of pins or wires directly into the bone, allowing for a stronger and more stable pull that is necessary for the realignment of complex fractures.
Choice D reason:
Skeletal traction carries a higher risk of infection compared to skin traction because it is more invasive. The insertion of pins or wires into the bone creates a potential entry point for bacteria, which can lead to infection at the site of insertion.
Correct Answer is B
Explanation
Choice A reason:
Purulent drainage at the intravenous site access site would indicate a more severe infection, possibly grade 3 or 4 on the Infusion Nurses Society's phlebitis scale. This would be associated with more advanced symptoms such as pus formation, which is not characteristic of grade 1 phlebitis.
Choice B reason:
Redness at the intravenous access site with pain is indicative of grade 1 phlebitis according to the Infusion Nurses Society's phlebitis scale. This grade is characterized by erythema and possible pain at the site of the IV insertion, without more severe symptoms such as swelling or streak formation.
Choice C reason:
Red streaks on the affected extremity suggest a progression of the inflammatory response, potentially indicating a higher grade of phlebitis, such as grade 2 or 3. This symptom suggests that the inflammation is spreading along the vein, which is more serious than grade 1 phlebitis.
Choice D reason:
A palpable venous cord in the affected extremity would also suggest a more severe form of phlebitis, likely grade 3. This occurs when a thrombus forms along with inflammation of the vein, leading to a palpable cord-like structure.