A client with frequent urinary tract infections asks the nurse if ...

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A client with frequent urinary tract infections asks the nurse if there is a chance of acute renal failure. The nurse explains that which of the following risk factors can lead to acute renal failure? (Select all that apply.)
 
  1. Ineffective wound healing
   2. Urinary tract obstruction
   3. Surgery
   4. Hypertension
   5. Low serum albumin

Question 2

A client who says she is about 6 weeks pregnant hears the baby's heartbeat for the first time through a Doppler. The nurse realizes which of the following?
 
  1. The mother is at 4 to 8 weeks' gestation.
   2. The mother is at 8 to 12 weeks' gestation.
   3. The mother is at 16 weeks' gestation.
   4. The mother is at 20 weeks' gestation.

[parshano]

Answer to Question 1

2. Urinary tract obstruction
3. Surgery
4. Hypertension

Rationale: Urinary obstruction, hypertension, and major surgery can all precipitate acute renal failure (ARF). Ineffective wound healing has not been shown to cause renal failure unless the infection becomes systemic. A low serum albumin does not cause ARF.

Answer to Question 2

2. The mother is at 8 to 12 weeks' gestation.

Rationale:
The ultrasonic Doppler device is the primary tool for assessing fetal heartbeat. It can detect fetal heartbeat, on average, at 8 to 12 weeks' gestation. If an ultrasonic Doppler is not available, a fetoscope may be used. The fetal heartbeat can be detected by fetoscope as early as week 16 and almost always by 19 or 20 weeks' gestation. The mother is not at 4 to 8 weeks' gestation because the Doppler device detected fetal heartbeat. If the mother has not yet heard the fetal heartbeat, she must be at less than 16 or 20 weeks' gestation.