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
Acute renal injury (ARI) is a term for a reversible syndrome that results in decreased glomerular filtration rate (GFR) and oliguria. GFR is a measure of how well the kidneys filter blood and oliguria is a condition of producing less than normal amounts of urine.
Choice B is wrong because chronic renal injury (CRI) is not a reversible syndrome, but a progressive loss of kidney function over months or years.
Choice C is wrong because end-stage renal disease (ESRD) is not a reversible syndrome, but a condition where the kidneys have lost most or all of their function and dialysis or transplantation is required.
Choice D is wrong because acute tubular necrosis (ATN) is not a term for a syndrome, but a specific type of acute kidney injury that involves damage to the tubules, the part of the nephron that reabsorbs water and solutes from the filtrate.
Correct Answer is ["23"]
Explanation
The correct answer is 22.5 mL.
To find the amount of mL, use the formula: (desired dose / available dose) x available volume.
In this case, desired dose = 30 mEq, available dose = 20 mEq, and available volume = 15 mL.
Plug these values into the formula: (30 mEq / 20 mEq) x 15 mL = 22.5 mL.
However, since the instructions say to round to the nearest whole number for adult clients, the final answer is 23 mL.
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