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 C
Explanation
A. Gentamicin is an aminoglycoside antibiotic used to treat bacterial infections. It is not appropriate for managing CKD directly and is generally avoided in patients with kidney impairment due to its potential nephrotoxicity.
B. Potassium supplements are typically not recommended unless there is a documented deficiency in potassium. In stage 3a CKD, managing potassium levels is crucial, but supplements are not usually needed unless potassium levels are low.
C. Captopril is an angiotensin-converting enzyme (ACE) inhibitor. ACE inhibitors are beneficial for patients with CKD as they help lower blood pressure and provide renal protective effects. They can reduce proteinuria (protein in urine), which is common in CKD, and may slow the progression of kidney disease.
D. Metformin is an oral medication used to manage type 2 diabetes by improving insulin sensitivity and lowering blood glucose levels. Although it is important to monitor blood glucose in CKD patients, this
client’s fasting blood glucose is within normal range (83 mg/dL), so Metformin is not indicated unless there was evidence of diabetes or significant glucose dysregulation.
Correct Answer is ["C","D"]
Explanation
A. Green beans are relatively low in potassium compared to other foods. While they do contain potassium, it is not in particularly high amounts. Therefore, they are generally considered safe in moderate amounts for individuals with CKD, but should still be monitored as part of a potassium- restricted diet.
B. Apples are low in potassium compared to many other fruits. They can be a good option for those needing to restrict potassium intake.
C. A typical serving of orange juice can contain a significant amount of potassium, which can contribute to elevated potassium levels in CKD patients. It should be limited or avoided to manage potassium intake effectively.
D. Avocados are high in potassium. A single avocado contains a substantial amount of potassium, making it a food that should be limited or avoided in a potassium-restricted diet for individuals with CKD.
E. Onions are relatively low in potassium and can be used in moderation by individuals with CKD. They are not typically a major concern for potassium restriction.
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