A client with acute kidney injury is receiving hemodialysis.
Which of the following interventions should the nurse prioritize during the dialysis treatment?
Monitoring the client's blood pressure every 4 hours.
Administering a loop diuretic before the treatment.
Assessing the client's respiratory status every 2 hours.
Monitoring the client's electrolyte levels before and after the treatment.
Monitoring the client's electrolyte levels before and after the treatment.
The Correct Answer is D
Monitoring the client’s electrolyte levels before and after the treatment. This is because acute kidney injury (AKI) can cause electrolyte imbalances such as hyperkalemia, hyperphosphatemia, hypocalcemia, and metabolic acidosis. Hemodialysis can help correct these imbalances by removing excess fluid and waste products from the blood. However, hemodialysis can also cause electrolyte shifts and complications such as hypotension, muscle cramps, and arrhythmias. Therefore, it is important to monitor the client’s electrolyte levels before and after the treatment to assess the effectiveness and safety of hemodialysis.
Choice A is wrong because monitoring the client’s blood pressure every 4 hours is not frequent enough during hemodialysis.
Hemodialysis can cause rapid changes in blood pressure due to fluid removal and vascular access.
Therefore, blood pressure should be monitored more often, such as every 15 to 30 minutes during hemodialysis.
Choice B is wrong because administering a loop diuretic before the treatment is not indicated for AKI patients receiving hemodialysis.
Loop diuretics are used to increase urine output and reduce fluid overload in AKI patients who have some residual kidney function.
However, hemodialysis can achieve the same goal by removing excess fluid from the blood.
Moreover, loop diuretics can cause electrolyte depletion and ototoxicity, which can worsen the condition of AKI patients.
Choice C is wrong because assessing the client’s respiratory status every 2 hours is not specific enough for hemodialysis treatment.
Hemodialysis can affect respiratory mechanics by altering fluid balance, acid- base status, and oxygen delivery.
Therefore, respiratory status should be assessed more frequently and comprehensively during hemodialysis, such as by measuring respiratory rate, oxygen saturation, arterial blood gas, and chest auscultation.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Angiotensin II is a hormone that stimulates the adrenal cortex to release aldosterone. Aldosterone is a hormone that helps regulate blood pressure by increasing the reabsorption of sodium and water and the excretion of potassium by the kidneys.
Choice A is wrong because renin is not a hormone but an enzyme that catalyzes the conversion of angiotensinogen to angiotensin I1.
Choice B is wrong because angiotensin I is an inactive precursor of angiotensin II that is converted by angiotensin-converting enzyme (ACE) in the lungs.
Choice D is wrong because antidiuretic hormone (ADH) is a hormone that regulates water balance by increasing the reabsorption of water by the kidneys, but it does not affect aldosterone secretion.
Correct Answer is B
Explanation
This is because hyponatremia is a condition where sodium levels in your blood are lower than normal, usually due to too much water in your body that dilutes the sodium. A hypertonic saline solution is a fluid that has a higher concentration of sodium than blood, and it can help restore the normal sodium balance by drawing water out of the cells.
Choice A is wrong because restricting fluid intake may not be enough to correct severe hyponatremia, and it may worsen the symptoms of dehydration.
Choice C is wrong because encouraging increased fluid intake will further lower the sodium levels and increase the risk of complications such as brain swelling.
Choice D is wrong because administering a loop diuretic will cause more sodium and water loss from the kidneys, which can worsen hyponatremia and dehydration.
Normal ranges for blood sodium levels are between 135 and 145 milliequivalents per liter (mEq/L).
Hyponatremia is defined as a blood sodium level below 135 mEq/L1.
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