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 D
Explanation
Nasogastric suction removes gastric secretions that contain potassium, leading to a loss of potassium from the body. This can cause hypokalemia, which is a low level of potassium in the blood.
Choice A is wrong because Addison’s disease causes hyperkalemia, which is a high level of potassium in the blood.
Choice B is wrong because tissue damage can release potassium from the cells into the blood, causing hyperkalemia.
Choice C is wrong because uric acid level is not related to potassium level.
Uric acid is a waste product of purine metabolism that can cause gout or kidney stones if elevated.
Correct Answer is A
Explanation
This is the only solution that is isotonic and compatible with blood products. It will not cause hemolysis or clotting of the blood cells.
Choice B is wrong because lactated Ringer’s is a balanced electrolyte solution that contains calcium, which can cause clotting of the blood cells.
Choice C is wrong because 5% dextrose is a hypotonic solution that can cause hemolysis of the blood cells.
Choice D is wrong because 5% dextrose in 0.45% sodium chloride is a hypertonic solution that can cause hemolysis of the blood cells.
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