The patient has a temporary percutaneous catheter in place for treatment of acute kidney injury. The catheter has been in place for 5 days. The nurse should

Correct Answer: B

Rationale: The correct answer is B: evaluate the patient for signs and symptoms of infection. After 5 days, infection risk increases. Signs of infection include fever, redness, swelling, and tenderness at the catheter site. Monitoring for these signs is crucial to prevent complications. A: Routine dialysis catheter change is not indicated after 5 days. C: Teaching long-term use is incorrect as temporary catheters are not meant for extended use. D: Using lumens for fluid administration can increase infection risk and is not recommended.

Correct Answer: C

Rationale: Step 1: Syndrome of inappropriate antidiuretic hormone (SIADH) leads to excess water retention, diluting sodium levels in the blood. Step 2: Fluid restriction is the mainstay of treatment to prevent further dilution of sodium. Step 3: Administering 3% normal saline (choice A) can worsen the condition by further increasing sodium levels. Step 4: Exogenous vasopressin (choice B) would exacerbate the problem by increasing water retention. Step 5: Low sodium diet (choice D) may be beneficial in the long term but is not the immediate priority.

Correct Answer: B

Rationale: The correct answer is B: deficiency of corticosteroids. Acute adrenal crisis is caused by a sudden and severe deficiency of cortisol and aldosterone, which are essential corticosteroids produced by the adrenal glands. Without these hormones, the body cannot regulate blood pressure, electrolyte balance, and respond to stress adequately. Acute renal failure (choice A) does not directly lead to adrenal crisis. High doses of corticosteroids (choice C) can suppress the adrenal glands but do not cause acute adrenal crisis. Overdose of testosterone (choice D) does not impact the production of cortisol and aldosterone, thus not causing acute adrenal crisis.

Correct Answer: B

Rationale: The correct answer is B: a decreased risk of peritonitis exists. Peritoneal dialysis involves using the peritoneum as a membrane for fluid exchange, reducing the risk of infections like peritonitis compared to hemodialysis. Option A is incorrect as peritoneal dialysis can be done at home and is less time-consuming than hemodialysis. Option C is incorrect as biochemical disturbances are corrected more gradually with peritoneal dialysis. Option D is incorrect as there is a risk of bleeding complications with peritoneal dialysis.

Correct Answer: A

Rationale: The correct answer is A: sepsis. Sepsis is a leading cause of acute kidney injury in critically ill patients due to the systemic inflammatory response leading to kidney damage. Fluid overload (B) can contribute but is not the primary cause. Medications (C) and hemodynamic instability (D) can also lead to acute kidney injury but are not as common as sepsis in critically ill patients.

Correct Answer: D

Rationale: The correct answer is D. Volume replacement and insulin infusion often correct the acidosis in diabetic ketoacidosis (DKA) because volume depletion and insulin deficiency are key factors in its pathophysiology. Volume replacement helps correct dehydration and improve tissue perfusion, while insulin infusion helps lower blood glucose levels and inhibit ketone production, ultimately correcting the acidosis. A is incorrect because serum lactate levels are not typically used to guide insulin administration in DKA. B is incorrect as sodium bicarbonate is not a first-line medication for DKA treatment as it can worsen metabolic acidosis. C is incorrect as the degree of acidosis in DKA is typically assessed through blood gas analysis, not continuous pulse oximetry.

Correct Answer: B

Rationale: The correct answer is B: fluid replacement with 0.45% saline. The patient's symptoms suggest dehydration and hypovolemia, indicated by low blood pressure, elevated heart rate, and lack of urine output. Fluid replacement with isotonic saline would help restore intravascular volume and improve blood pressure. Blood transfusion (A) is not indicated without evidence of significant blood loss. Inotropic agents (C) are used to improve cardiac function, which is not the primary issue in this case. Antiemetics (D) may help with nausea and vomiting but do not address the underlying cause of hypovolemia.

Correct Answer: D

Rationale: The correct answer is D because the presence of red blood cells and albumin in the urine indicates kidney damage, as these are not normally found in urine. A: Creatinine levels should be similar in blood and urine for proper kidney function. B: Sodium and chloride are normal components of urine. C: Uric acid levels can vary in urine and serum. Therefore, D is the correct answer as it signals potential kidney injury.

Correct Answer: A

Rationale: The correct answer is A: Kidney, ureter, bladder (KUB) x-ray. KUB x-ray is a noninvasive diagnostic procedure that provides information about the size, shape, and position of the kidneys, ureters, and bladder. It can help detect abnormalities such as kidney stones or structural issues. Rationale: 1. KUB x-ray is noninvasive, meaning it does not require any incisions or insertion of instruments into the body. 2. It is commonly used as an initial screening tool to assess kidney function. 3. Renal ultrasound (Choice B) is also noninvasive but primarily used for imaging the kidneys and not the entire urinary system. 4. MRI (Choice C) and IVP (Choice D) are more invasive procedures that involve injecting contrast agents and may not be routinely used for initial kidney function assessment. In summary, the KUB x-ray is the correct choice as it is a noninvasive procedure specifically designed to evaluate kidney