The nurse caring for a client reviews the medical record and determines the client is at risk for developing a potassium deficit because of which situation?

Monitoring the client’s electrolyte levels before and after the treatment. This is because acute kidney injury (AKI) can cause electrolyte imbalances such as hyperkalemia, hyperphosphatemia, hypocalcemia, and metabolic acidosis. Hemodialysis can help correct these imbalances by removing excess fluid and waste products from the blood. However, hemodialysis can also cause electrolyte shifts and complications such as hypotension, muscle cramps, and arrhythmias. Therefore, it is important to monitor the client’s electrolyte levels before and after the treatment to assess the effectiveness and safety of hemodialysis.

Choice A is wrong because monitoring the client’s blood pressure every 4 hours is not frequent enough during hemodialysis.

Hemodialysis can cause rapid changes in blood pressure due to fluid removal and vascular access.

Therefore, blood pressure should be monitored more often, such as every 15 to 30 minutes during hemodialysis.

Choice B is wrong because administering a loop diuretic before the treatment is not indicated for AKI patients receiving hemodialysis.

Loop diuretics are used to increase urine output and reduce fluid overload in AKI patients who have some residual kidney function.

However, hemodialysis can achieve the same goal by removing excess fluid from the blood.

Moreover, loop diuretics can cause electrolyte depletion and ototoxicity, which can worsen the condition of AKI patients.

Choice C is wrong because assessing the client’s respiratory status every 2 hours is not specific enough for hemodialysis treatment.

Hemodialysis can affect respiratory mechanics by altering fluid balance, acid- base status, and oxygen delivery.

Therefore, respiratory status should be assessed more frequently and comprehensively during hemodialysis, such as by measuring respiratory rate, oxygen saturation, arterial blood gas, and chest auscultation.

Uremia is a condition where there is an excess of urea and other nitrogenous wastes in the blood, usually excreted by the kidneys into the urine. It occurs when the kidneys stop filtering toxins out through your urine and can be a sign of end-stage renal (kidney) disease.

Choice A is wrong because azotemia is the buildup of nitrogen waste products in the blood, not urea.

Choice C is wrong because anuria is the absence or reduction of urine output.

Choice D is wrong because oliguria is the low output of urine.