The most common cause of acute kidney injury in critically ill patients is

Correct Answer: A

Rationale: The correct answer is A: sepsis. Sepsis is the leading cause of acute kidney injury in critically ill patients due to systemic inflammation and decreased blood flow to the kidneys. Sepsis can lead to septic shock, causing renal hypoperfusion. Fluid overload (B) can contribute to kidney injury but is not the most common cause. Medications (C) can cause kidney injury, but sepsis is more prevalent in critically ill patients. Hemodynamic instability (D) can lead to kidney injury, but sepsis is a more frequent cause in this population.

Correct Answer: C

Rationale: The correct answer is C: multiplied by 0.85. This adjustment accounts for the smaller muscle mass in women compared to men, leading to lower creatinine production. To calculate GFR, creatinine clearance is multiplied by 0.85 in women to adjust for this difference. This adjustment ensures a more accurate estimation of GFR in women. Choices A and B are incorrect because creatinine clearance is not the same or greater in women compared to men due to the physiological differences in muscle mass. Choice D is incorrect because multiplying by 1.15 would overestimate GFR in women.

Correct Answer: B

Rationale: The correct answer is B: Assess the patient's lungs. In rhabdomyolysis, muscle breakdown leads to the release of myoglobin which can cause renal damage. IV fluids and mannitol are given to prevent kidney injury. Assessing the patient's lungs is important to monitor for potential complications such as pulmonary edema, a serious side effect of mannitol therapy. This assessment will help the nurse detect any signs of respiratory distress early on, allowing for prompt intervention. Choices A, C, and D are incorrect: A: Assess the patient's hearing - This is not directly related to the treatment of rhabdomyolysis and mannitol administration. C: Decrease IV fluids once the diuretic has been administered - Decreasing IV fluids prematurely can lead to inadequate hydration and worsen kidney function. D: Give extra doses before giving radiological contrast agents - This is not indicated in the treatment of rhabdomyolysis and can potentially harm the patient.

Correct Answer: D

Rationale: The correct answer is D because it demonstrates an understanding of the relationship between PaCO2 and blood pH according to the principles of acid-base balance. When PaCO2 is acutely elevated, it leads to respiratory acidosis, causing the blood pH to decrease below normal levels due to the accumulation of carbon dioxide. This indicates an acidic environment in the blood. Choices A, B, and C are incorrect as they do not address the direct relationship between PaCO2 and blood pH, which is crucial in determining the acid-base balance in a patient.

Correct Answer: A

Rationale: Step 1: Clonic seizures are characterized by rhythmic jerking movements. Step 2: Apnea is the cessation of breathing. Step 3: Generalized clonic seizures associated with apnea can lead to hypoxemia (low oxygen in the blood). Step 4: Hypoxemia can result in lactic acidosis due to anaerobic metabolism. Conclusion: The correct answer is A because the patient experiencing generalized clonic seizures associated with periods of apnea is at risk for hypoxemia and subsequent lactic acidosis. Summary of other choices: B: Being alert is important but not directly related to the patient's condition. C: Base imbalance options are not relevant to the scenario provided. D: While lactic acidosis is mentioned, this choice does not directly address the association between clonic seizures, apnea, hypoxemia, and lactic acidosis.