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 A
Explanation
Choice A reason:
The inability to move toes can be an early sign that a cast is too tight. This symptom may indicate that the cast is impinging on nerves or blood vessels, leading to decreased motor function. It is essential to address this immediately to prevent further complications such as permanent damage or compartment syndrome.
Choice B reason:
Edema, or swelling of the toes, can occur if a cast is too tight, but it may not be the first sign observed. Swelling is a response to increased pressure in the tissues and can develop over time as fluid accumulates. While it is a concern, it often follows other symptoms such as changes in sensation or movement.
Choice C reason:
Pallor of the toes, indicating reduced blood flow, can be a sign of a cast that is too tight. However, pallor may not be as immediately noticeable as the inability to move toes or changes in sensation. It is still a critical sign that requires prompt evaluation and possible adjustment of the cast.
Choice D reason:
A change in the temperature of the toes, such as them becoming cooler to the touch, can suggest impaired blood flow due to a tight cast. This sign, along with pallor, may develop after other symptoms such as numbness or motor impairment.
Correct Answer is B
Explanation
Choice A reason:
The statement about using a natural membrane condom rather than a polyurethane condom is incorrect. Natural membrane condoms, such as those made from lambskin, have small pores that can allow viruses to pass through. Therefore, they are not recommended for the prevention of STIs. Polyurethane condoms, on the other hand, do not have these pores and are considered effective in preventing STIs, including HIV.
Choice B reason:
Female condoms, also known as internal condoms, are effective in preventing the transmission of sexually transmitted viruses, including HIV. They act as a barrier to prevent the exchange of bodily fluids during sexual activity, thereby reducing the risk of STI transmission. It's important to include this information in the teaching as it empowers individuals with an additional option for protection.
Choice C reason:
Condoms are designed for single use only. Using a condom more than once greatly increases the risk of condom failure, which can lead to the transmission of STIs or unintended pregnancy. It is crucial to emphasize the importance of using a new condom for each act of sexual intercourse.
Choice D reason:
Oil-based lubricants should not be used with latex condoms as they can weaken the material, leading to condom breakage. Instead, water-based or silicone-based lubricants are recommended as they do not damage the condom and can help prevent breakage.