A nurse is caring for a client with end-stage renal disease (ESRD). The client's blood work shows elevated levels of creatinine, blood urea nitrogen (BUN), and potassium. Which of the following conditions is the primary indication for initiating dialysis?

A) This statement is accurate. Clients on hemodialysis should limit their protein intake to reduce the workload on the kidneys and minimize waste buildup. Excess protein intake can lead to the accumulation of urea and other waste products, which can be challenging for the compromised kidneys to eliminate.

B) This statement is incorrect. While clients on hemodialysis may need to limit sodium intake to manage fluid retention and blood pressure, the primary nutrient that requires limitation in their diet is protein.

C) This statement is incorrect. Clients on hemodialysis may need to monitor their calcium intake, but it is not the primary nutrient that requires limitation in their diet. Calcium levels may be affected by the use of phosphate binders and the avoidance of high-phosphorus foods, but protein restriction is more critical.

D) This statement is incorrect. Iron intake may need to be managed for clients with anemia, which is common in end-stage renal disease (ESRD) and dialysis. However, protein restriction remains a more significant dietary consideration for clients on hemodialysis.

A) This statement is incorrect. Serum calcium levels are not directly related to ESA therapy for anemia management. ESA therapy focuses on increasing red blood cell production.

B) This statement is incorrect. Blood urea nitrogen (BUN) levels are indicators of kidney function and may be monitored for other reasons in a client on peritoneal dialysis. However, they are not directly related to ESA therapy for anemia management.

C) This statement is accurate. During ESA therapy, the nurse should closely monitor the client's hemoglobin and hematocrit levels. ESAs stimulate the production of red blood cells and can increase hemoglobin and hematocrit levels. Regular monitoring is essential to prevent anemia or excessive increases in these values.

D) This statement is incorrect. Serum potassium levels may be monitored for a client on peritoneal dialysis due to the potential for electrolyte imbalances, but they are not the primary concern during ESA therapy for anemia management.