A client is diagnosed with chronic kidney disease and needs to begin dialysis. Which condition entered on the client's medical record should the nurse recognize as a contraindication for peritoneal dialysis?
Type 2 diabetes mellitus.
Nephrotic syndrome history.
Latent hepatitis C
Crohn's disease with colectomy
The Correct Answer is D
A. Type 2 diabetes mellitus
Type 2 diabetes mellitus is not a contraindication for peritoneal dialysis. In fact, peritoneal dialysis can be a suitable option for individuals with diabetes who require renal replacement therapy. However, the presence of diabetes may require additional considerations and close monitoring.
B. Nephrotic syndrome history
Having a history of nephrotic syndrome is not a contraindication for peritoneal dialysis. Peritoneal dialysis can be used in individuals with various causes of chronic kidney disease, including those with nephrotic syndrome.
C. Latent hepatitis C
Latent hepatitis C alone may not be an absolute contraindication for peritoneal dialysis. However, the decision to initiate peritoneal dialysis would depend on the overall health status of the client, the degree of liver involvement, and the risk of infection. Close monitoring and appropriate precautions may be necessary.
D. Crohn's disease with colectomy
Crohn's disease with colectomy is considered a contraindication for peritoneal dialysis. Surgical alterations in the abdomen, such as colectomy, can lead to adhesions or other complications that may interfere with the effectiveness of peritoneal dialysis. In such cases, alternative forms of dialysis, such as hemodialysis, may be considered.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. Instruct the client to drink plenty of fluids during the treatment.
This option focuses on hydration, which is generally important during chemotherapy to flush out toxins and maintain overall health. However, it does not specifically address the risk of vesicant extravasation.
B. Keep the head of the bed elevated until the treatment is completed.
Keeping the head of the bed elevated is a measure that may be taken for certain conditions or treatments, but it is not directly related to preventing vesicant extravasation.
C. Monitor the client's intravenous site hourly during the treatment.
This is the correct choice. Monitoring the intravenous site for signs of extravasation, such as swelling, redness, or pain, is crucial when administering vesicant chemotherapy drugs. Early detection allows for prompt intervention to minimize potential tissue damage.
D. Administer an antiemetic before starting the chemotherapy.
Administering an antiemetic (a medication to prevent or alleviate nausea and vomiting) is important for managing side effects of chemotherapy, but it does not specifically address the prevention of vesicant extravasation.
Correct Answer is D
Explanation
A. Have the client sign the surgical and transfusion permits:
While obtaining signed consent is important, the immediate concern is addressing the client's medication history, especially the use of heparin, which can contribute to bleeding.
B. Ensure that the potential for bleeding is explained to the client:
Education about the potential for bleeding is important, but the immediate action is to communicate the client's medication history to the healthcare provider for appropriate guidance.
C. Observe the heparin injection sites for signs of bruising:
Monitoring for bruising at injection sites is a consideration, but it is not the priority when the client is actively bleeding from an open fracture.
D. Notify the healthcare provider of the client's medication history:
This is the correct answer. Heparin is an anticoagulant, and its use can increase the risk of bleeding during surgery. The healthcare provider needs to be informed of the client's current medication history to make decisions regarding the timing and management of heparin therapy in the perioperative period.
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