Which of the following laboratory data does the nurse anticipate ...

[B]

Which of the following laboratory data does the nurse anticipate for the client with chronic renal failure prior to hemodialysis?
 
  1. Increased urine osmolality
   2. Decreased phosphorus
   3. Decreased potassium
   4. Increased creatinine

Question 2

The nurse is caring for a client who sustained a brain injury and is no longer competent to make health care decisions. The nurse suggests that decisions for care:
 
  1. Be determined by the physician.
   2. Are the responsibility of social services.
   3. Be made by the agent named in the durable power of attorney.
   4. Be made by the client's spouse.

[princessflame2016]

Answer to Question 1

4. Increased creatinine

Rationale:
The damaged kidney is unable to excrete waste products, including creatinine, so it will be increased. The damaged kidney is unable to excrete solutes; therefore, the serum osmolality will be increased and the urine osmolality will be decreased. Both phosphorus and potassium increase during renal failure due to the inability of the kidney to excrete them.

Answer to Question 2

3. Be made by the agent named in the durable power of attorney.

Rationale:
The nurse, recognizing that the client is no longer competent, should follow whatever hospital policy is in place for contacting the agent named in a durable power of attorney for health care. The physician is not the appropriate person to make decisions for the client. Social services may be the department that would contact the agent of a durable power of attorney, but they would not be that power. In the case of an incompetent client, the spouse would be the agent of the durable power of attorney only if the court appointed the spouse.