A nurse is caring for a client who has end-stage renal disease (ESRD). Which of the following are expected findings? (Select all that apply).
Bone pain
Slurred speech
Hypotension
Pruritus
Bradypnea.
Correct Answer : A,B,D
A. Bone pain can occur in ESRD due to mineral and bone disorders associated with chronic kidney disease.
B. Slurred speech can be seen in ESRD patients with uremic encephalopathy.
C. Hypotension is less common in ESRD; hypertension is more typical due to fluid overload and retention.
D. Pruritus is a common symptom of ESRD, often due to accumulation of uremic toxins.
E. Bradypnea is not typically associated with ESRD.
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Related Questions
Correct Answer is D
Explanation
A. Edema in chronic kidney failure is more closely associated with sodium and water retention rather than protein intake.
B. Hyperkalemia in chronic kidney failure can be managed by restricting dietary potassium intake, but it is not primarily related to protein intake.
C. A low-protein diet aims to decrease, not increase, nitrogenous wastes in the blood.
D. A low-protein diet reduces the risk for uremia, a condition resulting from chronic kidney failure where urea and other waste products build up in the body due to impaired renal function. A low-protein diet helps decrease the workload on the kidneys by reducing the amount of nitrogenous waste they need to filter and excrete.
Correct Answer is A
Explanation
A. 0.45% sodium chloride, also known as half-normal saline, is a hypotonic solution with a lower concentration of sodium than normal serum levels. It can help to lower the sodium levels in a client with hypernatremia by diluting the excess sodium in the body.
B. Dextrose 10% in water is hypertonic and not appropriate for a client with hypernatremia, as it could exacerbate the imbalance.
C. Lactated Ringer's is isotonic and contains sodium in a similar concentration to serum levels, hence it could further increase the sodium levels.
D. Dextrose 5% in 0.9% sodium chloride (also known as D5NS) is a hypertonic solution that contains both dextrose and sodium. It would not be appropriate for a client with hypernatremia, as it could exacerbate the condition.
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