A male client develops acute renal failure (ARF) after receiving I.V. therapy with a nephrotoxic antibiotic. Because the client’s 24-hour urine output totals 240 ml, nurse Andy suspects that the client is at risk for:
- A. cardiac arrhythmia.
- B. paresthesia.
- C. dehydration.
- D. pruritus.
The correct answer is C. dehydration. Here's why:
- Acute renal failure (ARF):
This condition occurs when the kidneys suddenly lose their ability to filter waste products from the blood.
- Nephrotoxic antibiotic:
Certain antibiotics can damage the kidneys, contributing to ARF as in this case.
24-hour urine output of 240 ml: This is significantly less than the normal range of 1.5-2 L, indicating oliguria, a symptom of ARF and dehydration.
- Cardiac arrhythmia (A):
While ARF can affect electrolytes and potentially contribute to arrhythmias, oliguria in this context is a more direct indicator of dehydration and a more likely immediate concern.
- Paresthesia (B):
While this can be a symptom of electrolyte imbalances associated with ARF, it's not a primary concern based on the presented information.
- Pruritus (D):
This can be a symptom of chronic kidney disease, but not typically associated with acute episodes or dehydration.
Therefore, based on the client's ARF, oliguria, and the potential for dehydration due to the reduced urine output, nurse Andy is correct in suspecting dehydration as the primary immediate concern.
It's important to note that ARF can have various complications, and monitoring for other potential issues like electrolyte imbalances and infections is also crucial. However, in this specific scenario, dehydration is the most likely consequence of the low urine output and should be addressed promptly.
