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 A
Explanation
Metabolic acidosis is a condition in which there is excess acid in the body fluids.
It causes rapid breathing, confusion, tiredness, headache, and increased heart rate.
Rapid breathing is a compensatory mechanism that helps to lower the carbon dioxide levels and increase the pH of the blood.
Choice B is wrong because decreased respiratory rate would worsen the acidosis by retaining more carbon dioxide and lowering the pH of the blood.
Choice C is wrong because normal respiratory rate would not be adequate to compensate for the metabolic acidosis and would result in acidemia (low blood pH).
Choice D is wrong because irregular respiratory rate is not a typical response to metabolic acidosis and could indicate other problems such as brain injury or drug overdose.
Correct Answer is B
Explanation
Performing hand hygiene before and after handling the dialysis equipment is essential to prevent infection in peritoneal dialysis.
Hand washing and appropriate use of a mask can help avoid peritonitis, which is a serious complication of peritoneal dialysis.
Choice A is wrong because administering antibiotics prophylactically is not recommended for peritoneal dialysis patients, as it can increase the risk of antibiotic resistance and adverse effects.
Choice C is wrong because allowing the client to handle the dialysis equipment independently may increase the risk of contamination and infection.
The client should be supervised and instructed by a nurse on how to use sterile technique when connecting and disconnecting the transfer set.
Choice D is wrong because discontinuing the peritoneal dialysis if the client develops a fever may worsen the client’s condition and lead to fluid overload and electrolyte imbalance.
The client should be evaluated for signs of infection and treated accordingly.
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