A nurse is reviewing the medication record for a client who has chronic kidney disease. Which of the following medications should the nurse identify as having the potential to cause nephrotoxicity?
Ondansetron
Diphenhydramine
Gentamicin
Omeprazole
The Correct Answer is C
Rationale:
A. Ondansetron is an antiemetic that does not typically cause nephrotoxicity and is generally safe for use in clients with chronic kidney disease.
B. Diphenhydramine is an antihistamine that does not have nephrotoxic effects and is commonly used for allergy symptoms or as a sleep aid.
C. Gentamicin is an aminoglycoside antibiotic that is known to be nephrotoxic, especially in clients with pre-existing kidney disease. It requires careful monitoring of kidney function and dosing adjustments to prevent kidney damage.
D. Omeprazole is a proton pump inhibitor used to treat gastroesophageal reflux disease (GERD) and does not typically cause nephrotoxicity, although long-term use has been associated with an increased risk of chronic kidney disease.
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Correct Answer is A
Explanation
Rationale:
A. Smoking cessation is the most effective measure for preventing chronic bronchitis, as smoking is the leading cause of this condition.
B. Regular moderate exercise is beneficial for overall health and respiratory function but is not as directly effective in preventing chronic bronchitis as smoking cessation.
C. Maintaining an ideal weight is important for overall health but does not directly prevent chronic bronchitis.
D. Annual influenza immunization helps prevent respiratory infections that could exacerbate chronic bronchitis but does not prevent the development of the disease itself.
Correct Answer is B
Explanation
Rationale:
A. During the oliguric phase of acute kidney injury, BUN and creatinine levels typically increase due to reduced kidney function, not decrease.
B. The oliguric phase is characterized by significantly reduced urine output, often defined as less than 400 mL per 24 hours, indicating severe kidney impairment.
C. The GFR does not recover during the oliguric phase; it is significantly decreased, contributing to the accumulation of waste products in the blood.
D. Renal function is not reestablished during the oliguric phase; this occurs in later stages, such as the diuretic or recovery phase.