A male client with acute kidney injury (AKI) is scheduled for his first hemodialysis treatment and asks the practical nurse (PN) how the treatments will be evaluated for effectiveness. The PN explains that blood samples will be collected for analysis. Which laboratory value should the PN explain as the best indicator of each hemodialysis?
Elevated potassium.
Decreased calcium.
Lowered hemoglobin.
Decreased creatinine.
The Correct Answer is D
Hemodialysis is a procedure used to remove waste products and excess fluid from the blood when the kidneys are unable to function properly. One of the waste products that accumulate in the blood during kidney dysfunction is creatinine. Creatinine is a byproduct of muscle metabolism, and its levels in the blood are normally regulated and eliminated by the kidneys. In AKI, the kidneys are not able to effectively filter and eliminate creatinine, leading to elevated levels in the blood. Hemodialysis helps to remove excess creatinine from the blood, resulting in decreased creatinine levels.

A- Elevated potassium levels (hyperkalemia) are common in AKI and can be life-threatening. Hemodialysis helps to remove excess potassium from the blood, restoring normal levels.
However, the best indicator of the effectiveness of hemodialysis in managing hyperkalemia would be monitoring the potassium levels before and after the session rather than considering it as the "best" indicator.
B- Decreased calcium levels can occur in kidney dysfunction due to impaired activation of vitamin D and decreased absorption of calcium from the intestines. While hemodialysis can help restore calcium levels, it may not be the primary laboratory value used to evaluate the effectiveness of each session.
C- Lowered hemoglobin levels can be seen in AKI due to various factors, including decreased production of red blood cells and blood loss. Hemodialysis can help remove waste products and excess fluid, but it may not directly address the underlying causes of lowered hemoglobin levels.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
The client is prescribed oxygen at 3 liters per minute, but the flowmeter shows that only 1 liter of oxygen is being delivered. This indicates an inadequate oxygen supply and immediate action is required to adjust the flow rate to meet the prescribed oxygen requirement. Failure to provide the appropriate oxygen flow rate can compromise the client's respiratory status and oxygenation. The PN should promptly increase the flow rate to the prescribed level to ensure the client receives the necessary oxygen therapy.
The other assessment findings mentioned are also important to note and address, but they do not require immediate action:
A. The client lying in a supine position in bed: While it is generally recommended for clients receiving oxygen therapy to be in an upright or semi-upright position, this finding does not require immediate action unless there are specific indications or contraindications related to the client's condition.
B. The cannula pressed snugly against the client's cheeks: The cannula should fit comfortably and securely on the client's face without causing discomfort or pressure areas. While this finding may require adjustment to ensure proper fit and comfort, it does not require immediate action unless it is causing harm or compromising oxygen delivery.
D. There is no humidifier attached to the delivery system: While a humidifier may be recommended to add moisture to the oxygen, its absence does not pose an immediate threat to the client's safety or require immediate action. The need for humidification depends on the client's condition and comfort level, and it can be addressed by attaching a humidifier if necessary.

Correct Answer is B
Explanation
After a hip arthroplasty with prosthesis placement, it is important to follow specific precautions to protect the surgical site and prevent dislocation of the hip joint. One common precaution is to avoid excessive internal rotation, adduction, and f

The other observations mentioned in the scenario are correct and demonstrate appropriate knowledge of the turning procedure:
A. Placing an abduction pillow between the client's legs helps maintain proper alignment and prevents adduction of the legs, which can cause hip dislocation.
C. Keeping the back straight and knees bent when moving the client promotes proper body mechanics and reduces the risk of injury to the UAPs.
D. Using a turning sheet under the client for turning and repositioning helps reduce friction and shearing forces, making the process safer and more comfortable for the client.
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