A nurse is caring for a client who came to the emergency department reporting chest pain. The provider suspects a myocardial infarction. While waiting for the troponin levels report, the client asks what this blood test will show.
Which of the following explanations should the nurse provide to the client?

Choice a) is incorrect because calcium levels are not directly affected by hemodialysis. Calcium is a mineral that is important for bone health, blood clotting, and muscle contraction. Hemodialysis does not remove calcium from the blood, but it may cause low calcium levels if the dialysate fluid has a lower concentration of calcium than the blood.

Choice b) is correct because potassium levels are decreased by hemodialysis. Potassium is an electrolyte that is essential for nerve and muscle function, especially the heart. Hemodialysis removes excess potassium from the blood, which can build up in people with kidney failure and cause irregular heartbeats, muscle weakness, or even cardiac arrest.

Choice c) is incorrect because protein levels are not decreased by hemodialysis. Protein is a macromolecule that is composed of amino acids and performs various functions in the body, such as building and repairing tissues, transporting substances, and regulating processes. Hemodialysis does not remove protein from the blood, but it may cause low protein levels if the client has a poor diet or loses protein through other means, such as urine or wounds.

Choice d) is incorrect because RBC count is not decreased by hemodialysis. RBCs are red blood cells that carry oxygen throughout the body. Hemodialysis does not remove RBCs from the blood, but it may cause low RBC count if the client has anemia, which is a common complication of kidney failure. Anemia can be caused by reduced production of erythropoietin (a hormone that stimulates RBC production), iron deficiency, or blood loss.

The correct answer is: d. Brachial pulse in the right arm.

Choice A reason: Palpating the radial pulse in the right arm is not the most appropriate choice following a cardiac catheterization with a left antecubital insertion site. While it is contralateral to the insertion site, the brachial pulse is preferred over the radial pulse for assessing circulation in the arm, as it is more proximal and can provide a better indication of arterial flow from the catheterization site.

Choice B reason: The radial pulse in the left arm is the correct choice because it evaluates distal circulation in the affected limb. Since the catheterization was performed through the left antecubital fossa, it is crucial to monitor blood flow further down in the arm. Palpating the radial pulse helps detect early signs of compromised perfusion, such as diminished pulse strength. Evidence-based guidelines from clinical sources highlight the importance of distal pulse assessment post-catheterization.

Choice C reason: Palpating the brachial pulse in the left arm is also not recommended. Since the catheterization was performed on the left side, there is a risk of arterial occlusion or spasm, which could affect the accuracy of the pulse assessment in the left arm.

Choice D reason: The brachial pulse in the right arm does not provide relevant information about the left arm’s vascular status post-catheterization. Since the right arm was not affected by the procedure, its pulse does not indicate possible complications in the left arm. Clinical assessment should focus on detecting perfusion issues in the limb where the catheter was inserted. Best practices recommend prioritizing the evaluation of circulation in the affected extremity.