A client has a long history of hypertension. Which category of ...

[elizabeth18]

A client has a long history of hypertension. Which category of medications would the nurse expect to be ordered to avoid chronic kidney disease (CKD)?
 
  a. Antibiotic
  b. Histamine blocker
  c. Bronchodilator
  d. Angiotensin-converting enzyme (ACE) inhibitor

Question 2

The nurse is caring for four clients with chronic kidney disease. Which client should the nurse assess first upon initial rounding?
 
  a. Woman with a blood pressure of 158/90 mm Hg
  b. Client with Kussmaul respirations
  c. Man with skin itching from head to toe
  d. Client with halitosis and stomatitis

[matt]

Answer to Question 1

ANS: D
ACE inhibitors stop the conversion of angiotensin I to the vasoconstrictor angiotensin II. This category of medication also blocks bradykinin and prostaglandin, increases renin, and decreases aldosterone, which promotes vasodilation and perfusion to the kidney. Antibiotics fight infection, histamine blockers decrease inflammation, and bronchodilators increase the size of the bronchi; none of these medications helps slow the progression of CKD in clients with hypertension.

Answer to Question 2

ANS: B
Kussmaul respirations indicate a worsening of chronic kidney disease (CKD). The client is increasing the rate and depth of breathing to excrete carbon dioxide through the lungs. Hypertension is common in most clients with CKD, and skin itching increases with calcium-phosphate imbalances, another common finding in CKD. Uremia from CKD causes ammonia to be formed, resulting in the common findings of halitosis and stomatitis.

[elizabeth18]

TYSM

[31809pancho]

Excellent