A client with type 1 diabetes mellitus, hypertension, and chronic kidney disease is to begin hemodialysis treatment. Which statement should the nurse include in client education?
Prepare for an abdominal catheter.
Continue routine medications.
Expect the insulin dosage to be reduced.
Include potassium-rich foods in the diet.
The Correct Answer is C
Choice A reason: An abdominal catheter is used for peritoneal dialysis, not hemodialysis. Hemodialysis requires access to a large blood vessel, usually in the arm or leg.
Choice B reason: Routine medications may need to be adjusted or avoided before or after hemodialysis, depending on their effects on blood pressure, fluid balance, and electrolytes.
Choice C reason: Insulin dosage may need to be reduced during hemodialysis because insulin is removed by the dialyzer and blood glucose levels may drop. This is the correct statement to include in client education.
Choice D reason: Potassium-rich foods should be limited in the diet of clients with chronic kidney disease and hemodialysis, because potassium can build up in the blood and cause cardiac arrhythmias.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","B","C"]
Explanation
Choice A reason: Presenting a calm, supportive demeanor is an appropriate intervention for a client who is experiencing anxiety and hallucinations. The nurse should use a soothing tone of voice, maintain eye contact, and avoid arguing or challenging the client's perceptions. This can help reduce the client's agitation and promote trust.
Choice B reason: Reorienting to day and time frequently is an appropriate intervention for a client who is experiencing anxiety and hallucinations. The nurse should provide reality-based information and reminders about the client's situation, such as the reason for hospitalization, the name of the nurse, and the expected plan of care. This can help the client regain a sense of orientation and control.
Choice C reason: Administering an as needed (PRN) dose of lorazepam is an appropriate intervention for a client who is experiencing anxiety and hallucinations. Lorazepam is a benzodiazepine that can reduce anxiety, agitation, and psychotic symptoms by enhancing the effects of gamma-aminobutyric acid (GABA), an inhibitory neurotransmitter in the brain. The nurse should monitor the client's vital signs, level of sedation, and risk of falls after giving the medication.
Choice D reason: Turning the television on for distraction is not an appropriate intervention for a client who is experiencing anxiety and hallucinations. The television can increase the sensory stimulation and confusion for the client, and may worsen the hallucinations or delusions. The nurse should provide a quiet and safe environment for the client.
Choice E reason: Applying soft wrist restraints bilaterally is not an appropriate intervention for a client who is experiencing anxiety and hallucinations. Restraints can increase the anxiety and agitation for the client, and may cause physical or psychological harm. The nurse should use restraints only as a last resort when other less restrictive measures have failed to protect the client or others from harm.
Correct Answer is B
Explanation
Choice A reason: Sweet potatoes are not a food that the client should avoid after passing a calcium oxalate renal stone, because they are low in oxalate, which is a substance that can combine with calcium in the urine and form stones. The client should limit foods that are high in oxalate, such as spinach, rhubarb, beets, nuts, chocolate, tea, and wheat bran. Therefore, this choice is incorrect.
Choice B reason: Spinach salad is a food that the client should avoid after passing a calcium oxalate renal stone, because it is high in oxalate, which can increase the risk of stone formation. The client should consume foods that are low in oxalate, such as rice, corn, apples, grapes, peaches, and cheese. Therefore, this choice is correct.
Choice C reason: Bananas are not a food that the client should avoid after passing a calcium oxalate renal stone, because they are low in oxalate and high in potassium, which can help prevent stone formation. The client should increase the intake of fluids, calcium, and citrate, which can reduce the concentration of oxalate and calcium in the urine and inhibit stone formation. Therefore, this choice is incorrect.
Choice D reason: Fish is not a food that the client should avoid after passing a calcium oxalate renal stone, because it is low in oxalate and high in protein, which can help maintain muscle mass and prevent weight loss. The client should moderate the intake of animal protein, such as meat, poultry, eggs, and dairy products, which can increase the acidity of the urine and promote stone formation. Therefore, this choice is incorrect.
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