what dietary recommendations should be given to a patient with pre dialysis end stage kidney disease

ATI RN

ATI Capstone Adult Medical Surgical Assessment 2

1. What dietary recommendations should be given to a patient with pre-dialysis end-stage kidney disease?

A. Reduce phosphorus intake to 700 mg/day
B. Increase sodium intake
C. Increase protein intake
D. Increase potassium intake

Correct answer: A

Rationale: The correct recommendation for a patient with pre-dialysis end-stage kidney disease is to reduce phosphorus intake to 700 mg/day. High phosphorus levels can lead to complications in such patients. Increasing sodium intake (Choice B) is generally not recommended due to its association with hypertension and fluid retention. While protein is essential, increasing protein intake (Choice C) in kidney disease can be harmful as it can lead to increased waste products that the kidneys may struggle to excrete. Increasing potassium intake (Choice D) is not advisable as well, as patients with kidney disease may already have difficulty excreting potassium, leading to hyperkalemia.

2. What is the first nursing action for a patient with chest pain and possible acute coronary syndrome?

A. Administer sublingual nitroglycerin
B. Increase fluids to prevent dehydration
C. Obtain cardiac enzymes
D. Get IV access and auscultate heart sounds

Correct answer: A

Rationale: Administering sublingual nitroglycerin is the priority nursing action for a patient with chest pain and possible acute coronary syndrome. Nitroglycerin helps dilate the blood vessels, improve blood flow to the heart, and reduce cardiac workload. This action aims to relieve chest pain promptly and prevent further cardiac tissue damage. Increasing fluids is not the initial priority for a patient with chest pain and possible acute coronary syndrome. Obtaining cardiac enzymes is important for diagnosis but is not the first action in managing acute symptoms. Getting IV access and auscultating heart sounds are important interventions, but they come after administering sublingual nitroglycerin in the management of acute coronary syndrome.

3. What are the expected changes on an ECG for a patient with hypokalemia?

A. Flattened T waves
B. Prominent U waves
C. ST elevation
D. Wide QRS complexes

Correct answer: A

Rationale: Flattened T waves are an early sign of hypokalemia on an ECG. Hypokalemia primarily manifests as flattened T waves on an ECG. While prominent U waves can be seen in hypokalemia, they are not as specific as flattened T waves. ST elevation is more commonly associated with conditions like myocardial infarction rather than hypokalemia. Wide QRS complexes are typically not a feature of hypokalemia on an ECG.

4. What are the signs and symptoms of Increased Intracranial Pressure (IICP)?

A. Irritability, confusion, restlessness
B. Fatigue and SOB
C. Changes in pupillary response
D. Elevated blood pressure

Correct answer: A

Rationale: The correct answer is A: Irritability, confusion, restlessness. These are common signs of Increased Intracranial Pressure (IICP) as they result from the increased pressure on brain tissue. Choices B, C, and D are incorrect. Fatigue and shortness of breath (SOB) are not typical symptoms of IICP. Changes in pupillary response can be seen in other conditions but are not specific to IICP. Elevated blood pressure is not a common sign of IICP.

5. A nurse is teaching a client who has type 1 DM about hypoglycemia. Which of the following statements by the client indicates an understanding of the teaching?

A. Exercise reduces the risk for hypoglycemia.
B. I can skip my insulin when I don't eat.
C. I can drink 4 oz of soda if my blood sugar is low.
D. Diabetic pills don't cause hypoglycemia; only insulin does.

Correct answer: C

Rationale: The client can correct any development of hypoglycemia with a quick intake of glucose. The client should have 15 g carbohydrates on hand to treat hypoglycemic episodes, like 4 oz of regular soda.