The client has a history of renal failure and is receiving hemodialysis. The nurse should monitor for which electrolyte imbalance.
Hyperkalemia.
Hypokalemia.
Hyponatremia.
Hypernatremia.
The Correct Answer is A
This is because hemodialysis removes excess fluid and waste products from the blood, but it also removes some electrolytes, such as potassium.
Potassium is important for nerve and muscle function, especially the heart.
If potassium levels are too high or too low, it can cause irregular heartbeat or cardiac arrest.
Choice B is wrong because hypokalemia means low potassium levels, which is unlikely in renal failure unless there is excessive potassium loss from diarrhea, vomiting or diuretics.
Choice C is wrong because hyponatremia means low sodium levels, which can occur in renal failure due to fluid retention, but it is not directly related to hemodialysis.
Choice D is wrong because hypernatremia means high sodium levels, which can occur in renal failure due to reduced urine output, but it is also not directly related to hemodialysis.
Normal ranges for electrolytes are: Potassium: 3.5 to 5.0 mmol/L
Sodium: 135 to 145 mmol/L
Calcium: 8.5 to 10.5 mg/dL
Chloride: 96 to 106 mmol/L
Magnesium: 1.7 to 2.2 mg/dL
Phosphate: 2.5 to 4.5 mg/dL
Bicarbonate: 22 to 29 mmol/L
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Serum creatinine is a waste product that comes from muscle activity and is normally removed by the kidneys.
When the kidneys are damaged, the serum creatinine level rises.
The glomerular filtration rate (GFR) is a measure of how well the kidneys are filtering the blood and it is calculated from the serum creatinine level.
A normal GFR is 60 or more, while a GFR below 60 may indicate kidney disease.
Therefore, monitoring the serum creatinine level and the GFR can help assess the renal function in CKD.
Choice A is wrong because blood glucose level is not a direct indicator of renal function, although high blood glucose can damage the kidneys over time.
Choice C is wrong because serum albumin level is not a specific marker of renal function, although low serum albumin can be caused by protein loss in the urine due to kidney damage.
Choice D is wrong because white blood cell count is not related to renal function, but rather to immune system activity and infection.
Normal ranges for serum creatinine are 0.6 to 1.2 mg/dL for men and 0.5 to 1.1 mg/dL for women.
Normal ranges for GFR are 90 to 120 mL/min.
Normal ranges for serum albumin are 3.4 to 5.4 g/dL1.
Normal ranges for white blood cell count are 4,000 to 11,000 cells per microliter.
Correct Answer is D
Explanation
Protein intake can increase the excretion of calcium and oxalate in the urine, which can promote the formation of calcium oxalate stones. The client should limit animal protein sources, such as meat, poultry, fish, eggs, and dairy products.
Choice A is wrong because purine-rich foods, such as organ meats, shellfish, and beer, can increase the production of uric acid, which can cause uric acid stones.
Choice B is wrong because a low-calcium diet can increase the absorption of oxalate in the intestine, which can increase the risk of calcium oxalate stones.
The client should consume a moderate amount of calcium from dietary sources, such as milk, cheese, yogurt, and green leafy vegetables.
Choice C is wrong because potassium-rich foods, such as bananas, oranges, potatoes, and tomatoes, can help prevent calcium oxalate stones by increasing the urinary pH and citrate levels.
The client should consume adequate amounts of potassium from dietary sources.
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