A clinic nurse receives messages on 4 clients. Which client should the nurse call back first?

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The kidneys regulate fluid volume and blood pressure. Because renal damage often results in elevated blood pressure, clients with chronic kidney disease are at risk for uncontrolled hypertension and hypertensive emergencies. Hypertensive encephalopathy is a type of hypertensive crisis characterized by nausea, vomiting, and headache (Option B). Treatment is urgent (ie, within 1 hour) to prevent damage to the heart, kidney, and brain. The client should check blood pressure at home, if possible, and then proceed to the emergency department for further assessment and treatment (eg, titration of antihypertensive medication). (Option A) Celiac disease is an autoimmune disorder that interferes with the digestion of gluten. Diarrhea and foul-smelling stools are expected findings for this client, especially if noncompliant with a gluten-free diet. (Option C) Nausea and diarrhea are possible side effects of many antibiotics. The nurse should inquire about fever and frequency of diarrhea, as antibiotic use could also cause Clostridium difficile infection. However, this does not take priority over a client with a potentially life-threatening hypertensive crisis. (Option D) Nausea, vomiting, and diarrhea are signs of acute gastroenteritis (ie, food poisoning). Most symptoms of food poisoning resolve spontaneously in several hours to days and are usually not life-threatening. Encouraging adequate oral hydration is important. Educational objective: The kidneys regulate fluid volume and blood pressure. Renal damage causes high blood pressure. Nausea, vomiting, and headache could be signs of a hypertensive crisis and require immediate further assessment.

A Clinic Nurse Receives Messages on 4 Clients