A client with chronic kidney disease develops hypocalcemia.
Which electrolyte imbalance is most commonly associated with this condition?

Post-operative skin graft care focuses on maximizing graft take by reducing edema and preventing shearing. Knowledge of tissue perfusion and fluid dynamics is necessary to prioritize actions that minimize swelling, which can lift the graft from the bed.

Choice A rationale

Elevating the affected extremity reduces edema at the graft site by promoting venous return. Excessive swelling can separate the new graft from the underlying vascular bed, preventing necessary revascularization and leading to graft failure or necrosis.

Choice B rationale

Inspecting the graft site is important, but the nurse should generally not disturb the initial surgical dressing. Frequent inspection increases the risk of shearing or dislodging the delicate graft before it has successfully adhered to the site.

Choice C rationale

Ensuring the patient does not lie on the graft is a standard intervention to prevent pressure and shearing. However, in the presence of noted edema, elevation is the priority action to ensure the graft remains viable.

Choice D rationale

Administering analgesics addresses the pain level of 6/10, which is important for comfort. However, pain is expected, whereas reducing edema through elevation is functionally more critical to the physiological success and survival of the graft.

The scenario requires applying family systems theory and interdisciplinary communication principles within hospice care. Effective coping begins by clarifying the support structure available to the family, necessitating an understanding of how various professional roles function to alleviate the burden of end of life care.

Choice A rationale

Planning for hospital readmission contradicts the primary goal of hospice, which focuses on maintaining a comfortable home death. Focusing on hospitalization initially can create anxiety and undermine the family's confidence in managing the client's care at home.

Choice B rationale

Hospice typically provides intermittent visits rather than continuous 24-hour home care. Suggesting the nurse will meet all daily basic needs is unrealistic and provides false expectations, which can negatively impact the family's long-term ability to cope with caregiving.

Choice C rationale

While bereavement support is a standard component of hospice services, discussing post-death visits during the initial assessment is premature. Families need immediate support strategies and role clarity to manage the active dying process before focusing on aftercare services.

Choice D rationale

Clarifying the roles of the interdisciplinary team empowers the family by identifying specific resources for physical, emotional, and spiritual needs. This foundational knowledge reduces uncertainty, establishes a support network, and is the essential first step in facilitating effective coping.