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?
Hypertension
Hypercalcemia
Hyperkalemia
Hypokalemia
The Correct Answer is C
A) This statement is incorrect. Hypertension (high blood pressure) is a common complication of kidney disease, but it is not the primary indication for initiating dialysis. Dialysis is primarily indicated to address the impaired filtration and waste removal functions of the kidneys, which can lead to electrolyte imbalances like hyperkalemia.
B) This statement is incorrect. Hypercalcemia (elevated calcium levels) is not a primary indication for initiating dialysis. While calcium imbalances can be associated with kidney disease, hyperkalemia takes precedence as a more critical indication for dialysis initiation.
C) This statement is accurate. Hyperkalemia (elevated potassium levels) is a critical indication for initiating dialysis. Dialysis helps remove excess potassium from the bloodstream when the kidneys are unable to do so, preventing potentially life-threatening complications.
D) This statement is incorrect. Hypokalemia (low potassium levels) is not an indication for initiating dialysis. In fact, dialysis may lead to a reduction in potassium levels, and clients on dialysis are more likely to experience hyperkalemia.
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Related Questions
Correct Answer is D
Explanation
A) This statement is incorrect. Hypokalemia (low potassium levels) is not an indication for initiating dialysis. In AKI, electrolyte imbalances can occur, but hyperkalemia is more likely due to impaired kidney function.
B) This statement is incorrect. Hyponatremia (low sodium levels) is not a primary indication for initiating dialysis in AKI. It can occur due to fluid shifts, but the primary concern in AKI is the accumulation of waste products like urea, leading to uremia.
C) This statement is incorrect. Hypernatremia (high sodium levels) is not a primary indication for initiating dialysis in AKI. Hypernatremia is rare in AKI and usually occurs when there is a significant loss of free water compared to sodium intake.
D) Uremia, which is characterized by elevated levels of urea and other waste products in the blood, is a critical indication for initiating dialysis in clients with acute kidney injury. Dialysis helps remove these toxic substances from the bloodstream.
Correct Answer is B
Explanation
A) This statement is incorrect. Hemodialysis does not involve the removal of the peritoneal membrane; that description is characteristic of peritoneal dialysis.
B) This statement is accurate. Hemodialysis uses a machine called a dialyzer to filter blood outside the body, removing waste products and excess fluid before returning the clean blood to the patient.
C) This statement is incorrect. Hemodialysis does not rely on a catheter inserted into the bladder; that description is characteristic of urinary catheterization.
D) This statement is incorrect. Hemodialysis does not use a pump to circulate dialysate through the intestines; that description is characteristic of peritoneal dialysis.
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