A nurse is providing discharge teaching to a client who has chronic kidney disease and is receiving haemodialysis. Which of the following instructions should the nurse include in the teaching?
Eat 1 g/kg of protein per day.
Drink at least 3 L of fluid daily.
Consume foods high in potassium.
Take magnesium hydroxide for ingestion.
The Correct Answer is A
Choice A reason:
Eating 1 g/kg of protein per day is the appropriate recommendation. When providing discharge teaching to a client with chronic kidney disease (CKD) who is receiving haemodialysis, the nurse should include the instruction to eat an appropriate amount of protein, which is usually recommended at a specific daily intake based on the client's weight.
Clients with CKD often have dietary restrictions, including limiting protein intake to reduce the workload on the kidneys. However, protein intake is still necessary for maintaining muscle mass and overall health. The recommended protein intake for clients with CKD undergoing haemodialysis is typically around 1 gram of protein per kilogram of body weight per day.
Choice B reason:
Drink at least 3 L of fluid daily. Clients receiving haemodialysis typically have fluid restrictions, as impaired kidney function can lead to fluid retention and electrolyte imbalances. The specific fluid allowance will be determined by the healthcare provider based on the client's individual needs, and it may be significantly less than 3 L per day.
Choice D option
Take magnesium hydroxide for ingestion. Magnesium hydroxide is a laxative and antacid used to relieve constipation and heartburn. It is not typically prescribed for clients with chronic kidney disease, especially without proper evaluation of their kidney function and overall medical condition.
Choice C option:
C. Consume foods high in potassium.
Clients with chronic kidney disease, especially that undergoing haemodialysis, often need to restrict potassium intake. Impaired kidney function can lead to the build-up of potassium in the blood, which can be harmful. Therefore, it is essential for clients with CKD to avoid or limit foods high in potassium.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
The correct answer is choice D. Sit with the client to provide a sense of security.
A client who is experiencing a panic attack has a very high level of anxiety and a diminished ability to focus.
The nurse should stay with the client and remain calm and reassuring during the panic attack. This can help the client feel safe and supported, and reduce the intensity of the anxiety.
Choice A is wrong because atomoxetine is not an anti-anxiety medication, but a selective norepinephrine reuptake inhibitor (SNRI) used to treat attention deficit hyperactivity disorder (ADHD). It has no effect on reducing anxiety and can cause side effects such as insomnia, nausea, and increased blood pressure.
Choice B is wrong because encouraging the client to watch television is not a therapeutic intervention for a panic attack.
Watching television can increase the stimuli in the client’s environment, which can worsen the anxiety.
The nurse should maintain an environment with low stimulation for the client experiencing a panic attack. Dim lighting, few people, and minimal distractions can assist the nurse to decrease the client’s level of anxiety.
Choice C is wrong because teaching the client how to meditate is not appropriate during a panic attack.
Meditation is a relaxation technique that can be helpful for preventing or reducing anxiety, but it requires concentration and focus, which are impaired in a panic attack. The nurse should teach the client how to meditate when the client is calm and receptive, not when the client is in crisis.
Correct Answer is A
Explanation
The correct answer is choice A. INR.
Warfarin is a vitamin K antagonist that inhibits the synthesis of factors II, VII, IX, and X in the liver.
These factors are part of the extrinsic and common pathways of coagulation, which are measured by the prothrombin time (PT) and the international normalized ratio (INR).
The INR is a standardized way of reporting the PT that accounts for the variability of different reagents and instruments.
The INR is used to monitor the therapeutic effect of warfarin and to adjust the dose accordingly.
The target INR range depends on the indication for warfarin, but it is usually between 2 and 3 for most conditions.
Choice B is wrong because fibrinogen level is not affected by warfarin.
Fibrinogen is a precursor of fibrin, which forms the final step of the coagulation cascade.
Fibrinogen level can be decreased in conditions such as disseminated intravascular coagulation (DIC), liver disease, or severe bleeding. Choice C is wrong because aPTT is not affected by warfarin.
aPTT measures the intrinsic and common pathways of coagulation, which are mainly dependent on factors VIII, IX, XI, and XII.
These factors are not inhibited by warfarin.
aPTT is used to monitor the effect of heparin, a direct antithrombin agent that inhibits thrombin and factor Xa.
Choice D is wrong because platelet count is not affected by warfarin.
Platelets are cell fragments that adhere to damaged blood vessels and form aggregates to initiate hemostasis.
Platelet count can be decreased in conditions such as immune thrombocytopenia (ITP), heparin-induced thrombocytopenia (HIT), or bone marrow suppression.
Normal ranges:
- INR: 0.8-1.2
- Fibrinogen: 200-400 mg/dL
- aPTT: 25-35 seconds
- Platelet count: 150-450 x 10^9/L References:
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