A nurse is caring for a client who has end-stage kidney disease and will soon begin hemodialysis treatments. Which of the following restrictions should the nurse discuss with the client that may impact their quality of life? (Select all that apply.)

Restricting airplane travel

Driving restrictions

Time constraints

Limiting social activities to twice a week

Restricting foods high in potassium, sodium, and phosphorus

Restricting fluid intake

Answer and Explanation

Correct Answer : C,E,F

Choice A rationale
Restricting airplane travel is not typically necessary for patients on hemodialysis unless there are specific medical concerns or complications related to their condition.

Choice B rationale
Driving restrictions are not a standard restriction for patients with end-stage kidney disease unless there are other underlying conditions that impair the ability to drive safely.

Choice C rationale
Time constraints are a significant factor for patients on hemodialysis due to the frequent and lengthy treatment sessions, which can limit their availability for other activities.

Choice D rationale
Limiting social activities to twice a week is not a standard recommendation; social interactions are important for mental health and should be encouraged as much as the patient's health allows.

Choice E rationale
Restricting foods high in potassium, sodium, and phosphorus is crucial for patients with end-stage kidney disease to help manage electrolyte levels and prevent complications.

Choice F rationale

Restricting fluid intake is essential for patients on hemodialysis to prevent fluid overload, which can lead to heart failure and other serious health issues.

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Correct Answer is A

Explanation

Choice A rationale
This method is the standard procedure for obtaining a clean-catch midstream urine specimen. The initial voiding washes away organisms near the meatus, and the midstream urine is less likely to be contaminated by bacteria from the skin or urethral area, providing a sample that more accurately represents the bacteria in the bladder.

Choice B rationale
Having the patient empty the bladder completely and then obtaining the next specimen does not ensure a clean-catch sample. This method could lead to contamination of the specimen with bacteria from the skin or urethral area.

Choice C rationale
Cleaning the area with povidone-iodine is not recommended for routine urine culture as it may kill some of the bacteria, leading to a false-negative result. The standard practice is to clean the area with mild soap and water.

Choice D rationale
Inserting a catheter is an invasive procedure and is not the first choice for obtaining a urine specimen. It is used when a patient is unable to provide a clean-catch specimen or if there are specific medical indications.

A. Place the patient on a cardiac monitor. B. Insert a urinary retention catheter. C. Give the prescribed spironolactone. D. Administer epoetin alfa (Epogen).

Correct Answer is A

Explanation

Choice A rationale
In the case of hyperkalemia, which can cause fatal cardiac arrhythmias, the most immediate nursing action is to place the patient on a cardiac monitor. This allows for continuous monitoring of the heart's rhythm and immediate detection of any life-threatening changes, which is crucial for timely intervention.

Choice B rationale
Inserting a urinary retention catheter may be necessary for managing oliguria, but it is not the most urgent action when compared to the potential cardiac risks associated with hyperkalemia.

Choice C rationale
Administering spironolactone, a potassium-sparing diuretic, could be part of the treatment for hyperkalemia, but it is not the first action to take. Spironolactone works more slowly and does not address the immediate risk of cardiac arrhythmias.

Choice D rationale
Epoetin alfa (Epogen) is used to treat anemia, particularly in chronic kidney disease, to increase red blood cell production. However, it does not have an immediate effect and is not the priority in the presence of hyperkalemia and potential cardiac complications.

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A nurse is caring for a client who has end-stage kidney disease and will soon begin hemodialysis treatments. Which of the following restrictions should the nurse discuss with the client that may impact their quality of life? (Select all that apply.)

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A female patient with a suspected urinary tract infection is to provide a clean-catch midstream urine specimen for culture and sensitivity testing. What should the nurse do to obtain the specimen?

Correct Answer is A

Explanation

A patient admitted with acute kidney injury due to dehydration has oliguria, anemia, and hyperkalemia. Which prescribed action should the nurse take first?

Correct Answer is A

Explanation

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