Nursing A Hemodialysis Patient Quiz

The correct answer is Potassium 7.1 mEq/L. In patients with chronic kidney disease, high levels of potassium can lead to hyperkalemia, which can cause EKG abnormalities such as tall peaked T-waves. Therefore, the elevated potassium level confirms the abnormality seen on the telemetry strip.

A patient with chronic kidney disease (CKD) has a low erythropoietin (EPO) level, which is a hormone responsible for stimulating the production of red blood cells. This low EPO level can lead to a decreased production of red blood cells, resulting in anemia. Anemia is a condition characterized by a low level of red blood cells, leading to symptoms such as fatigue, weakness, and shortness of breath. Therefore, the patient with CKD and low EPO level is at risk for anemia.

The client's symptoms of sudden shortness of breath, chest pain, tachycardia, pallor, and anxiety are consistent with an air embolism. An air embolism occurs when air enters the bloodstream and can be life-threatening. The priority action for the nurse is to discontinue dialysis immediately to prevent further air from entering the bloodstream. Notifying the physician is also important to ensure prompt medical intervention. Monitoring vital signs every 15 minutes and continuing dialysis at a slower rate are not appropriate actions in this situation. Bolusing the client with normal saline may not effectively break up the air embolism and could potentially worsen the condition.

Assessing the fistula for the presence of a bruit and thrill every 4 hours is important to promote the client's safety because it allows the nurse to monitor the patency and function of the AV fistula. A bruit is a humming sound caused by turbulent blood flow through the fistula, indicating adequate blood flow. A thrill is a vibration felt over the fistula, indicating proper arterial-venous connection. Regular assessment of these signs can help detect any complications or changes in the fistula's function, allowing for prompt intervention and prevention of complications such as clotting or infection.

Patients with stage 4 chronic kidney disease often have impaired kidney function, which can lead to the accumulation of waste products in the blood. A low protein diet is recommended to reduce the production of waste products from protein metabolism. Additionally, a low sodium diet helps to control fluid balance and blood pressure, while a low potassium diet helps to prevent hyperkalemia. Finally, a low phosphate diet is important to manage mineral and bone disorders associated with kidney disease. Therefore, a low protein, low sodium, low potassium, low phosphate diet is the most appropriate recommendation for this patient.

The most important intervention for the client to prevent infection after a kidney transplant is to observe asepsis. Asepsis refers to the practice of maintaining a sterile environment and following strict infection control measures. This is crucial for preventing the introduction of pathogens that could potentially cause infections in the client, especially since they have end-stage renal disease and have undergone a recent transplant. Increasing fluid intake, avoiding clients with the flu, and avoiding crowded places can also be beneficial in reducing the risk of infection, but observing asepsis is the most important intervention in this case.

Pallor, diminished pulse, and pain are signs and symptoms that indicate a complication related to stealing syndrome in a hemodialysis client with a newly created left arm fistula. Stealing syndrome occurs when blood flow is diverted from the extremities to the fistula, resulting in decreased blood supply to the affected limb. Pallor, or paleness, is a result of reduced blood flow, while diminished pulse indicates decreased circulation. Pain may be present due to inadequate oxygen and nutrient supply to the tissues. These symptoms suggest that the fistula is causing insufficient blood flow to the extremity and should be addressed promptly.

Following a renal transplant, the nurse should assess the client for signs of acute graft rejection. Fever, hypertension, graft tenderness, and malaise are all indicative of acute graft rejection. Fever and malaise are common signs of inflammation and immune response, while hypertension and graft tenderness suggest that the transplanted kidney is being rejected by the recipient's immune system. This combination of symptoms should prompt further evaluation and intervention to prevent further complications.

The correct answer is to ensure that small clamps are attached to the arteriovenous shunt dressing. This is because the client with an external arteriovenous shunt is at risk for bleeding, and attaching small clamps to the dressing can help prevent any accidental dislodgement or bleeding from the shunt. Checking the shunt for the presence of bruit and thrill is important, but it is not the priority action in this situation. Observing the site once during the shift may not provide adequate monitoring for bleeding. Checking the results of the prothrombin time is important, but it is not the priority action in preventing bleeding.

Excessive amounts of calcium in the blood can lead to the formation of crystallized white deposits on the skin, a condition known as calcinosis cutis. In patients with Stage 5 CKD (Chronic Kidney Disease), the kidneys are unable to properly filter and excrete calcium, leading to its accumulation in the blood. This can result in symptoms such as extreme pruritus (itchiness) and the formation of calcium deposits on the skin. Therefore, the correct answer is calcium.