A nurse is developing a plan of care for a client who is to begin receiving peritoneal dialysis. Which of the following interventions should the nurse implement to ensure proper dialysate exchange?

Maintain the client in a left lateral position during dialysis.

Monitor vital signs every 2 hours during the procedure.

Warm the dialysate solution prior to instillation.

Place the drainage bag above the level of the client's abdomen.

Answer and Explanation

The Correct Answer is C

Choice A reason: Maintaining the client in a left lateral position is not specifically required for peritoneal dialysis. Positioning may vary based on the individual's comfort and specific medical needs.

Choice B reason: While monitoring vital signs is important during any medical procedure, it is not an intervention that directly ensures proper dialysate exchange in peritoneal dialysis.

Choice C reason: Warming the dialysate solution prior to instillation is a standard practice in peritoneal dialysis. It helps to promote patient comfort and more efficient exchange of wastes and fluids.

Choice D reason: Placing the drainage bag above the level of the client's abdomen would impede gravity drainage, which is necessary for proper dialysate exchange. The drainage bag should be placed below the level of the client's abdomen.

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Correct Answer is A

Explanation

Choice A reason: In acute kidney injury (AKI), the blood urea nitrogen (BUN) level is expected to be elevated due to the kidneys' impaired ability to excrete urea, which is a waste product of protein metabolism. Normal BUN levels range from approximately 7 to 20 mg/dL.

Choice B reason: Hypercalcemia is not commonly associated with AKI. Instead, patients with AKI may experience hypocalcemia due to the kidneys' reduced ability to convert vitamin D to its active form, which is necessary for calcium absorption.

Choice C reason: Metabolic alkalosis is not a typical finding in AKI. More commonly, patients with AKI experience metabolic acidosis because the kidneys are unable to excrete acid effectively, leading to an accumulation of acid in the body.

Choice D reason: Hypokalemia is generally not expected in AKI. The condition is more often associated with hyperkalemia, as the impaired kidney function leads to a reduced excretion of potassium, which can accumulate to dangerous levels.

A. A raised red rash around the fistula site B. Coldness and numbness distal to the fistula site C. Pain in the right arm proximal to the fistula site D. Foul-smelling drainage from the fistula site

Correct Answer is B

Explanation

Choice A reason: A raised red rash is not typically indicative of venous insufficiency but could suggest an allergic reaction or infection.

Choice B reason: Coldness and numbness distal to the fistula site can indicate poor blood flow, which is a symptom of venous insufficiency.

Choice C reason: Pain proximal to the fistula site can be a sign of venous hypertension and insufficiency, as it may

indicate increased pressure in the veins.

Choice D reason: Foul-smelling drainage is not a typical sign of venous insufficiency but may indicate an infection.

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A nurse is developing a plan of care for a client who is to begin receiving peritoneal dialysis. Which of the following interventions should the nurse implement to ensure proper dialysate exchange?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is B

Explanation

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