The client with chronic renal failure is scheduled for hemodialysis at 9 am. They are scheduled to receive oral daily medications. Which statement best describes when the nurse should administer the medications?

During dialysis

Give as scheduled

After returning from dialysis

Hold the medications for today and restart tomorrow

Answer and Explanation

The Correct Answer is C

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.

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Correct Answer is C

Explanation

A. Bradypnea, dizziness, and paresthesia: Bradypnea is associated with CO₂ retention, but paresthesia (tingling sensations) is more common in alkalosis due to calcium shifts.

B. Bradycardia and hyperactivity: Bradycardia can occur in severe acidosis, but hyperactivity is not a typical sign.

C. Headache, restlessness, and confusion: Respiratory acidosis occurs when CO₂ retention leads to cerebral vasodilation, increasing intracranial pressure and causing headache, restlessness, and confusion.

D. Irritability and seizures: Seizures are more common in severe alkalosis due to neuronal hyperexcitability.

A. Chloride level would be decreed B. Sodium level would be elevated C. Magnesium level would be elevated. D. Potassium level would be decreased

Correct Answer is A

Explanation

A. Chloride level would be decreased: Metabolic alkalosis is often associated with hypochloremia, especially when caused by vomiting or diuretics. However, hypokalemia is more clinically significant.

B. Sodium level would be elevated: Sodium levels are not directly affected by metabolic alkalosis.

C. Magnesium level would be elevated: Magnesium levels are not significantly altered in metabolic alkalosis.

D. Potassium level would be decreased: A bicarbonate level of 30 mEq/L indicates metabolic alkalosis. In alkalosis, hydrogen ions shift out of the cells, and potassium moves into the cells, leading to hypokalemia.

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The client with chronic renal failure is scheduled for hemodialysis at 9 am. They are scheduled to receive oral daily medications. Which statement best describes when the nurse should administer the medications?

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