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 D
Explanation
Choice A reason:
Monitoring temperature is important postoperatively as it can indicate infection or inflammation. However, it is not the immediate priority following a thyroidectomy. The primary concern post-thyroidectomy is ensuring the airway is not compromised due to swelling or bleeding.
Choice B reason:
Monitoring urination is part of postoperative care to ensure kidney function and that the body is adequately eliminating fluids. While important, it is not the priority in the immediate postoperative period following a thyroidectomy.
Choice C reason:
Pain control is essential for patient comfort and recovery. However, while managing pain is a significant aspect of postoperative care, it is not the most critical priority following a thyroidectomy. The nurse must first ensure that the airway is clear.
Choice D reason:
Airway patency is the priority for monitoring a client post-thyroidectomy. Due to the proximity of the surgery to the trachea, there is a risk of swelling, hematoma, or other complications that could lead to airway obstruction. Ensuring the client has a patent airway is crucial to prevent respiratory distress or compromise.
Correct Answer is D
Explanation
Choice A reason:
The statement that symptoms can worsen with penile penetration during intercourse is partially correct. While sexual activity may exacerbate feelings of bulging or discomfort associated with uterine prolapse, it does not typically worsen the prolapse itselfâš. Painful intercourse, known as dyspareunia, is a common symptom of pelvic organ prolapse, which includes uterine prolapse.
Choice B reason:
Feeling a sensation of pressure in the pelvis is a classic symptom of uterine prolapse. As the uterus descends into the vaginal canal, it can create a sensation of fullness or pressure that is often noticeable and uncomfortable for the patient.
Choice C reason:
Low back pain is indeed a symptom that can be associated with uterine prolapse. The weakening of pelvic floor muscles and ligaments that leads to prolapse can also contribute to discomfort in the lower back.
Choice D reason:
The presence of feces in the vagina would not be a direct symptom of uterine prolapse. However, a related condition called rectocele, where the rectum bulges into the vagina, could cause such a symptom. This condition is different from uterine prolapse and would require separate management.