A client with chronic kidney disease (CKD) is experiencing severe metabolic acidosis, which is not responding to medical management. Which of the following is the primary indication for initiating dialysis in this client?

Hypernatremia

Hyperkalemia

Hypocalcemia

Severe metabolic acidosis

Answer and Explanation

The Correct Answer is D

A) This statement is incorrect. Hypernatremia (high sodium levels) is not the primary indication for initiating dialysis in this case. Metabolic acidosis and the inability of the kidneys to excrete acids are the primary concerns.

B) This statement is incorrect. Hyperkalemia (elevated potassium levels) may occur in CKD, but it is not the primary indication described in the scenario. Metabolic acidosis is the primary concern leading to the need for dialysis.

C) This statement is incorrect. Hypocalcemia (low calcium levels) can be a complication of CKD, but it is not the primary indication for initiating dialysis in this scenario. Metabolic acidosis and its associated symptoms take precedence.

D) Severe metabolic acidosis, which results from the kidneys' inability to adequately excrete acids and regulate pH balance, is a critical indication for initiating dialysis in clients with CKD.

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Correct Answer is D

Explanation

A) This statement is incorrect. Hypokalemia (low potassium levels) is not an indication for initiating dialysis. In AKI, electrolyte imbalances can occur, but hyperkalemia is more likely due to impaired kidney function.

B) This statement is incorrect. Hyponatremia (low sodium levels) is not a primary indication for initiating dialysis in AKI. It can occur due to fluid shifts, but the primary concern in AKI is the accumulation of waste products like urea, leading to uremia.

C) This statement is incorrect. Hypernatremia (high sodium levels) is not a primary indication for initiating dialysis in AKI. Hypernatremia is rare in AKI and usually occurs when there is a significant loss of free water compared to sodium intake.

D) Uremia, which is characterized by elevated levels of urea and other waste products in the blood, is a critical indication for initiating dialysis in clients with acute kidney injury. Dialysis helps remove these toxic substances from the bloodstream.

A. Serum calcium levels B. Blood urea nitrogen (BUN) levels C. Hemoglobin and hematocrit levels D. Serum potassium levels

Correct Answer is C

Explanation

A) This statement is incorrect. Serum calcium levels are not directly related to ESA therapy for anemia management. ESA therapy focuses on increasing red blood cell production.

B) This statement is incorrect. Blood urea nitrogen (BUN) levels are indicators of kidney function and may be monitored for other reasons in a client on hemodialysis. However, they are not directly related to ESA therapy for anemia management.

C) This statement is accurate. During ESA therapy, the nurse should closely monitor the client's hemoglobin and hematocrit levels. ESAs stimulate the production of red blood cells and can increase hemoglobin and hematocrit levels. Regular monitoring is essential to prevent anemia or excessive increases in these values.

D) This statement is incorrect. Serum potassium levels may be monitored for a client on hemodialysis due to the potential for electrolyte imbalances, but they are not the primary concern during ESA therapy for anemia management.

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A client with chronic kidney disease (CKD) is experiencing severe metabolic acidosis, which is not responding to medical management. Which of the following is the primary indication for initiating dialysis in this client?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client with acute kidney injury (AKI). The client's urine output is significantly reduced, and laboratory tests show elevated levels of blood urea nitrogen (BUN) and creatinine. Which of the following is the primary indication for initiating dialysis in this client?

Correct Answer is D

Explanation

A client on hemodialysis is prescribed erythropoietin-stimulating agents (ESAs) to manage anemia. Which of the following laboratory values should the nurse monitor closely during ESA therapy?

Correct Answer is C

Explanation

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