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

Restricting airplane travel

Limiting social activities to twice a week

Time constraints

Driving restrictions

Restricting fluid intake

Restricting foods high in potassium, sodium, and phosphorus

Answer and Explanation

Correct Answer : C,D,E,F

A. Restricting airplane travel is not typically a restriction for clients undergoing hemodialysis. With appropriate planning, travel can still be possible, though it may require adjustments such as scheduling dialysis treatments while traveling. Therefore, it may not have a major impact on quality of life for most clients.
B. Limiting social activities to twice a week is not a typical restriction associated with hemodialysis. Although dialysis treatments may limit the time available for activities, it does not specifically limit social interactions to twice a week unless the client’s health deteriorates.
C. Time constraints are a significant concern. Hemodialysis typically requires the client to spend several hours (usually 3-5 hours) per session, 3 times a week, which can disrupt daily routines, work, and personal activities. This can impact the client’s quality of life.
D. Driving restrictions may apply. Many clients on hemodialysis are advised not to drive immediately after dialysis treatments due to potential fatigue, dizziness, or changes in blood pressure. This can impact the client's ability to travel independently and manage daily activities.
E. Restricting fluid intake is a common and critical aspect of hemodialysis. Clients with end-stage kidney disease need to be very careful about how much fluid they consume because their kidneys cannot excrete excess fluid effectively. This restriction can lead to discomfort and can significantly impact quality of life.
F. Restricting foods high in potassium, sodium, and phosphorus is important for clients with end-stage kidney disease undergoing hemodialysis. These dietary restrictions help maintain electrolyte balance and prevent complications like hyperkalemia and hyperphosphatemia, which can be life-threatening. However, adhering to these dietary restrictions can impact social and cultural aspects of the client's life and overall enjoyment of food.

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Correct Answer is C

Explanation

A. Provide an activity schedule that changes from day to day is not ideal for clients with Alzheimer's disease. Consistency and routine are important for these clients to reduce confusion and anxiety. A changing schedule may be overwhelming and disorienting.
B. Limit time for the client to perform activities may be inappropriate, as it is important to allow the client to maintain as much independence as possible. While safety and comfort are priorities, limiting time can increase frustration and a sense of dependency.
C. Talk the client through tasks one step at a time is the best option. Breaking tasks into small, manageable steps and giving clear, simple instructions can help the client with Alzheimer's disease maintain their independence and reduce confusion. This approach promotes a sense of accomplishment and reduces feelings of frustration.
D. Rotate assignment of daily caregivers is not ideal. Consistency in caregivers helps the client feel more secure and reduces anxiety. Frequent changes in caregivers can cause confusion and distress, as the client may struggle with recognizing new individuals and adjusting to new routines.

A. Spending time sitting with the client B. Encouraging decision-making C. Playing a game of chess with the client D. Giving the client choices of activities

Correct Answer is A

Explanation

A. Spending time sitting with the client is the correct and most therapeutic approach. Clients with severe depression often feel isolated and may have difficulty engaging in conversation or activities. Simply sitting quietly with the client shows presence, support, and acceptance, which can help build trust and provide comfort without placing pressure on the client to interact.
B. Encouraging decision-making may be inappropriate in the early stages of severe depression, as the client might feel overwhelmed or incapable of making even simple decisions due to impaired concentration and low motivation.
C. Playing a game of chess with the client may be too cognitively demanding and potentially frustrating for a client in a severely depressed state. It is better reserved for when the client is showing signs of improvement.
D. Giving the client choices of activities might seem supportive, but offering too many choices can increase anxiety and indecisiveness in someone who is severely depressed. Early in treatment, it's more helpful to offer structured support rather than open-ended decisions.

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

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