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 B
Explanation
Hyponatremia is a condition where sodium levels in your blood are lower than normal. This can cause symptoms such as nausea, headache, confusion, muscle weakness and seizures. A hypertonic saline solution is a fluid that has a higher concentration of sodium than normal blood. It can help restore the sodium balance and prevent or treat the complications of hyponatremia.
Choice A is wrong because restricting fluid intake may not be enough to correct severe hyponatremia and may worsen the symptoms if the cause is sodium loss.
Choice C is wrong because encouraging increased fluid intake may further dilute the sodium levels and worsen the condition.
Choice D is wrong because administering a loop diuretic may increase the urine output and cause more sodium loss, leading to more severe hyponatremia.
Normal ranges for blood sodium levels are between 135 and 145 milliequivalents per liter (mEq/L).
Correct Answer is B
Explanation
This is a priority nursing intervention for a client with acute kidney injury (AKI) because it helps to assess the renal function and fluid status of the client. Urine output is also an indicator of the response to treatment and the need for further interventions.
Choice A is wrong because pain medication is not a priority intervention for AKI unless the client has other conditions that cause pain.
Pain medication may also have adverse effects on the kidney function and should be used with caution.
Choice C is wrong because ambulation is not a priority intervention for AKI and may not be appropriate for a client who is fluid overloaded or hypotensive.
Ambulation may also increase the risk of falls and injury in a client who is confused or fatigued.
Choice D is wrong because assisting with meals is not a priority intervention for AKI and may not be necessary for a client who has adequate oral intake.
A client with AKI may also have dietary restrictions such as low protein, low potassium, low sodium, and low phosphorus, which should be considered when providing meals.
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