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3 Cards in this Set
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A nurse is reinforcing teaching with a client who has gout and urolithiasis. The client asks how to prevent future uric acid stones. Which of the following suggestions should the nurse make? (Select all that apply.) a. Take allopurinol as prescribed. b. Exercise several times a week. c. Limit intake of foods high in purine. d. Decrease daily fluid intake. e. Avoid lemonade. |
a. Take allopurinol as prescribed. Correct. The nurse should inform the client that allopurinol is an antigout medication that reduces levels of uric acid, which helps prevent uric acid stone formation.b. Exercise several times a week
Correct. The nurse should inform the client that immobility is a risk factor for urinary stasis and stone formation; therefore, the client should maintain a healthy lifestyle, including regular exercise, to help prevent stone formation.c. Limit intake of foods high in purine Correct. The nurse should inform the client that purine increases the risk for uric acid stone formation. The nurse should identify that organ meats, poultry, fish, red wine, and gravies are high in purine.d. Decrease daily fluid intake is incorrect. The nurse should inform the client that adequate fluid intake of 2 to 3 L per day reduces the risk of stone formation.e. Avoid citrus juices is incorrect. The nurse should inform the client that citrus juices help to alkalinize the urine, which helps prevent uric acid stone formation. |
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A nurse is reviewing a client’s laboratory report. The client’s ABG levels are pH 7.5, PaCO2 32 mm HG, and HCO3- 24 mEq/L. The nurse should determine that the client has which of the following acid-base imbalances? a. Respiratory alkalosis b. Metabolic acidosis c. Respiratory acidosis d. Metabolic alkalosis |
a. Respiratory alkalosis CORRECT. The nurse should identify that the client’s pH is elevated above the expected reference range of 7.35 to 7.45, indicating alkalosis. The nurse should then identify that the client’s PaCO2 is low, below the expected reference range of 35 to 45 mm Hg, which indicates a respiratory origin. The nurse should conclude that the client’s elevated pH and decreased PaCO2 indicate respiratory alkalosis. b. Metabolic acidosis The nurse should recognize that ABGs are drawn to determine acid-base balance in the arterial blood. Acidosis is determined by measuring a pH lower than the expected reference range of 7.35 to 7.45. This client has a pH of 7.5 and therefore does not have acidosis. c. Respiratory acidosis The nurse should recognize that ABGs are drawn to determine acid-base balance in the arterial blood. The client’s pH is elevated above the expected reference range of 7.35 to 7.45. Acidosis is presented by a lower pH, usually below 7.35. d. Metabolic alkalosis The nurse should recognize that ABGs are drawn to determine acid-base balance in the arterial blood. This client does not have a metabolic origin for abnormal ABGs. Metabolic origin is determined by examining the HCO3- levels. The client’s bicarbonate is within the expected reference range of 22 to 26 mEq/L. |
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