A client with end-stage renal disease (ESRD) is experiencing severe fatigue, weakness, and decreased urine output. 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?

Hyperkalemia

Hypophosphatemia

Uremia

Hyponatremia

Answer and Explanation

The Correct Answer is C

A) This statement is incorrect. Hyperkalemia (elevated potassium levels) can be a concern in ESRD, but it is not the primary indication described in the scenario. While hyperkalemia may occur in ESRD, the primary concern leading to the need for dialysis is the uremia and its associated symptoms.

B) This statement is incorrect. Hypophosphatemia (low phosphorus levels) can be a concern in ESRD, but it is not the primary indication for initiating dialysis in this case. Uremia and its associated symptoms are the primary concerns leading to the need for dialysis.

C) 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 end-stage renal disease. Dialysis helps remove these toxic substances from the bloodstream and may alleviate symptoms like fatigue, weakness, and decreased urine output.

D) This statement is incorrect. Hyponatremia (low sodium levels) is not the primary indication for initiating dialysis in this scenario. Uremia and the accumulation of waste products are the primary concerns that require dialysis to address.

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Correct Answer is B

Explanation

A. Incorrect. Warming the dialysate fluid to body temperature before instilling it into the peritoneal cavity is a standard procedure in continuous ambulatory peritoneal dialysis (CAPD. .

B. Correct. Performing the exchanges in a clean, dry environment free from pets is crucial to prevent contamination and reduce the risk of infection during CAPD.

C. Incorrect. Using tap water to cleanse the catheter insertion site before the exchange is not recommended. The catheter exit site should be cleaned with an appropriate antiseptic solution as instructed by the healthcare provider.

D. Incorrect. While daily dressing changes are important, using sterile technique for catheter dressing changes may not be necessary, as the dressing does not directly contact the peritoneal cavity during CAPD exchanges.

A. Hypermagnesemia B. Hyperphosphatemia C. Hyperkalemia D. Hypervolemia

Correct Answer is D

Explanation

A) This statement is incorrect. Hypermagnesemia (elevated magnesium levels) can be a concern in ESRD, but it is not a primary indication for initiating dialysis. Magnesium levels can be managed through dietary restrictions and medications without the need for dialysis.

B) This statement is incorrect. Hyperphosphatemia (elevated phosphorus levels) is a common issue in ESRD, but it is not a primary indication for initiating dialysis. Clients with ESRD may receive phosphate binders to control phosphorus levels without necessarily needing immediate dialysis.

C) This statement is incorrect. Hyperkalemia (elevated potassium levels) is a concern in ESRD, but it is not the primary indication described in the scenario. While hyperkalemia may occur with fluid overload, the primary concern in this case is the hypervolemia and its associated symptoms.

D) Hypervolemia (severe fluid overload) is a critical indication for initiating dialysis in clients with end-stage renal disease. Dialysis helps remove excess fluid from the body and can relieve symptoms such as pulmonary edema and hypertension.

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A client with end-stage renal disease (ESRD) is experiencing severe fatigue, weakness, and decreased urine output. 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?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who is on continuous ambulatory peritoneal dialysis (CAPD. . What should the nurse include in the client's education regarding self-care during exchanges?

Correct Answer is B

Explanation

A nurse is caring for a client with end-stage renal disease (ESRD). The client presents with severe fluid overload, pulmonary edema, and uncontrolled hypertension. Which of the following is the primary indication for initiating dialysis in this client?

Correct Answer is D

Explanation

A nurse is providing education to a client starting hemodialysis. The client asks about dietary restrictions. Which of the following nutrients should the nurse recommend limiting for a client on hemodialysis?

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A nurse is caring for a client undergoing hemodialysis. What is the nurse's priority action during dialysis?

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