The Assessment Patient Process
The Assessment Patient Process ( 6 Questions)
A nurse is evaluating a client who has chronic kidney disease (CKD) and is receiving hemodialysis.
Which finding indicates that the client's nutritional status is improving?
A serum albumin level of 4.0 g/dL indicates that the client's nutritional status is improving, as albumin is a protein that reflects the client's protein intake and nutritional status. The normal range for serum albumin levels is 3.5 to 5.0 g/dL.
This finding indicates that the client's nutritional status is worsening, as BUN is a waste product of protein metabolism that accumulates in the blood due to impaired renal function. A high BUN level can indicate excessive protein intake or inadequate dialysis. The normal range for BUN levels is 10 to 20 mg/dL.
This finding indicates that the client has fluid retention, not improved nutritional status. Dry weight is the weight of the client after dialysis, when all excess fluid has been removed. A weight gain of more than 1 kg above the dry weight can indicate inadequate fluid restriction or dialysis.
This finding indicates that the client has impaired renal function, not improved nutritional status. Creatinine is a waste product of muscle metabolism that accumulates in the blood due to reduced glomerular filtration rate (GFR). A high creatinine level can indicate decreased muscle mass or inadequate dialysis. The normal range for serum creatinine levels is 0.6 to 1.2 mg/dL.
The client's serum albumin level is 4.0 g/dL.
Rationale: A serum albumin level of 4.0 g/dL indicates that the client's nutritional status is improving, as albumin is a protein that reflects the client's protein intake and nutritional status. The normal range for serum albumin levels is 3.5 to 5.0 g/dL.
Incorrect options:
B) The client's blood urea nitrogen (BUN) level is 60 mg/dL. - This finding indicates that the client's nutritional status is worsening, as BUN is a waste product of protein metabolism that accumulates in the blood due to impaired renal function. A high BUN level can indicate excessive protein intake or inadequate dialysis. The normal range for BUN levels is 10 to 20 mg/dL.
C) The client's body weight is 2 kg higher than the dry weight. - This finding indicates that the client has fluid retention, not improved nutritional status. Dry weight is the weight of the client after dialysis, when all excess fluid has been removed. A weight gain of more than 1 kg above the dry weight can indicate inadequate fluid restriction or dialysis.
D) The client's serum creatinine level is 3.0 mg/dL. - This finding indicates that the client has impaired renal function, not improved nutritional status. Creatinine is a waste product of muscle metabolism that accumulates in the blood due to reduced glomerular filtration rate (GFR). A high creatinine level can indicate decreased muscle mass or inadequate dialysis. The normal range for serum creatinine levels is 0.6 to 1.2 mg/dL.