A client with end-stage renal disease (ESRD) has been on hemodialysis for 3 years. The client chooses to discontinue dialysis, and to begin receiving hospice services at home with day-to-day care provided by family members. The hospice nurse performs an assessment on the client 7 days after the client last received a dialysis treatment. Which assessment finding would not be expected for this client?
Pruritis
Lethargy
Polyuria
Uremic frost
The Correct Answer is C
A. This is a common symptom of uremia, which is the buildup of waste products in the blood due to kidney failure. It is expected in a patient with ESRD who has discontinued dialysis.
B. As the body accumulates waste products, fatigue and lethargy are common symptoms of uremia. This is expected in a patient with ESRD who has discontinued dialysis.
C. Polyuria is excessive urination. With kidney failure, the kidneys are unable to concentrate urine, leading to oliguria or anuria, not polyuria. Therefore, polyuria would not be expected in this patient.
D. This is a white, crystalline deposit on the skin caused by the accumulation of urea and uric acid. It is a sign of severe uremia and would be expected in a patient with ESRD who has discontinued dialysis.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. This is a pre-renal cause of acute kidney injury, related to decreased blood flow to the kidneys.
B. This is a post-renal cause of acute kidney injury, as it obstructs the outflow of urine.
C. This is an intrarenal cause of acute kidney injury, directly affecting the kidney tissue.
D. This is an intrarenal cause of acute kidney injury, related to damage to the small blood vessels in the kidneys.
Correct Answer is A
Explanation
A. Hematocrit measures the proportion of blood volume that is occupied by red blood cells. Epoetin alfa stimulates red blood cell production, so a therapeutic effect would be indicated by an increase in hematocrit levels. This is a key laboratory result to monitor when assessing the effectiveness of epoetin alfa in treating anemia in CKD patients.
B. Serum potassium levels are important to monitor in CKD patients due to the risk of hyperkalemia, but they are not directly affected by epoetin alfa. Decreasing serum potassium is not a primary indicator of the therapeutic effect of epoetin alfa.
C. Platelet count measures the number of platelets in the blood, which are crucial for blood clotting. Epoetin alfa is not designed to affect platelet counts; thus, a change in platelet count is not an indicator of the medication's therapeutic effect.
D. White blood cell count reflects the immune system's status and is not directly influenced by epoetin alfa. This medication specifically targets red blood cell production and does not impact white blood cell counts.
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