A nurse is providing education to a client who is reviewing a consent form for a surgical procedure. Which of the following statements by the client indicates an understanding of the consent?

Choice A reason: Anuria, minimal or no urine output, is expected in end-stage kidney disease (ESKD) due to nephron loss, reducing glomerular filtration rate. This causes fluid and toxin buildup, requiring dialysis to manage fluid balance and prevent complications like uremia in ESKD clients.
Choice B reason: Edema results from impaired sodium and water excretion in ESKD, causing fluid overload. Reduced filtration leads to volume retention, manifesting as peripheral or pulmonary edema, increasing cardiovascular strain and necessitating diuretics or dialysis to control fluid status effectively.
Choice C reason: Hyperkalemia occurs in ESKD, as failing kidneys cannot excrete potassium, elevating serum levels. This risks cardiac arrhythmias due to disrupted membrane potentials. Dietary restrictions or dialysis are needed to manage potassium, preventing life-threatening complications in end-stage renal failure.
Choice D reason: Hypocalcemia in ESKD stems from impaired vitamin D activation and phosphate retention, binding calcium. This disrupts bone mineralization and neuromuscular function, causing tetany or fractures. Calcium supplementation and dialysis correct this imbalance, addressing renal failure’s metabolic consequences.
Choice E reason: Metabolic acidosis in ESKD results from impaired hydrogen ion excretion and bicarbonate reabsorption. This lowers blood pH, causing fatigue and bone demineralization. Dialysis or bicarbonate therapy corrects acid-base imbalances, addressing the kidneys’ failure to maintain homeostasis in end-stage disease.

Choice A reason: Keeping the drainage bag above waist level promotes urine backflow, increasing infection risk. Bags must be below bladder level to ensure proper urine flow, so this action is incorrect and unsafe, requiring nurse intervention.
Choice B reason: Disconnecting the catheter to empty the bag breaks the closed system, increasing infection risk. The bag should be emptied via the drainage port, so this action is incorrect and requires correction by the nurse.
Choice C reason: Emptying the drainage bag when three-quarters full prevents overfilling, reducing backflow and infection risk. This aligns with proper catheter care protocols, ensuring safety for a fall-risk client, making it the correct technique.
Choice D reason: Using sterile gloves for emptying the drainage bag is unnecessary, as clean gloves suffice for this non-sterile procedure. Sterile gloves are for catheter insertion, so this action is incorrect and inefficient, requiring guidance.