The client receiving hemodialysis is complaining of being dizzy and light-headed. Which action should the nurse implement first?

Obtain vital signs

Bolus the client with 1000 m of normal saline

Turn off the dialysis machine immediately

Notify the health care provider as soon as possible

Answer and Explanation

The Correct Answer is A

A. Obtain vital signs: Dizziness and lightheadedness during dialysis suggest hypotension, a common complication. The nurse should first assess vital signs to determine the severity before taking further action.

B. Bolus the client with 1000 mL of normal saline: If the client is hypotensive, a smaller fluid bolus (e.g., 250–500 mL) would be more appropriate.

C. Turn off the dialysis machine immediately: Stopping dialysis abruptly may cause fluid overload and other complications. The rate may need adjustment but not immediate cessation.

D. Notify the health care provider as soon as possible: While important, assessing the client’s current status is the priority before contacting the provider.

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Correct Answer is C

Explanation

A. During dialysis: Some drugs can bind to the dialysis membrane or be removed unpredictably.

B. Give as scheduled: If given before dialysis, the drugs may be removed from circulation.

C. After returning from dialysis: Dialysis removes medications from the bloodstream. Giving medications before dialysis may result in drug loss. Oral medications should be given after dialysis to ensure proper absorption and effectiveness.

D. Hold the medications for today and restart tomorrow: Unnecessary, as the client needs their medications post-dialysis.

A. BUN 45 mg/dL and creatinine 8 mg/dL B. BUN 10 mg/dL and creatinine 0.3 mg/dL C. BUN 8 mg/dL, and creatinine 0.7 mg/dL D. BUN 23 mg/dl and creatinine 1.0 mg/dL

Correct Answer is A

Explanation

A. BUN 45 mg/dL and creatinine 8 mg/dL: In CKD, BUN (> 20 mg/dL) and creatinine (> 1.2 mg/dL) are significantly elevated due to reduced kidney function. A creatinine of 8 mg/dL indicates severe renal impairment.

B. BUN 10 mg/dL and creatinine 0.3 mg/dL: Too low for CKD, suggestive of normal renal function.

C. BUN 8 mg/dL, creatinine 0.7 mg/dL: Normal values.

D. BUN 23 mg/dL, creatinine 1.0 mg/dL: Mild elevation, but not consistent with CKD severity.

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The client receiving hemodialysis is complaining of being dizzy and light-headed. Which action should the nurse implement first?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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