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The nurse is caring for a 32-year-old female patient coming to the clinic with peripheral edema, periorbital edema, and flank pain. Use the chart to answer the questions.

Exhibits

Which items should the nurse include when teaching the patient and family about dialysis? Select all that apply.

signs of polycythemia

Need for fluid restrictions

Obtain a daily weight

Frequent oral care

Normal protein in the diet

Avoid nephrotoxic substances

Decrease sodium in the diet

Close monitoring of urine output

Answer and Explanation

Correct Answer : B,C,D,E,G,H

A.   Polycythemia (an abnormally high red blood cell count) is not typically a primary concern in dialysis patients; instead, they are more often monitored for anemia.
B.   Dialysis patients often need to restrict fluid intake to prevent fluid overload, which can exacerbate edema and cause additional cardiovascular strain.
C.   Daily weight monitoring is crucial for dialysis patients to track fluid balance and detect any sudden changes that might indicate fluid retention or loss.
D.   Frequent oral care is important to prevent infections, particularly because dialysis patients are at increased risk due to their compromised immune systems and possible fluid restrictions, which can lead to dry mouth and other oral health issues.
E.   Dialysis patients may need a modified protein intake, depending on their specific needs and the type of dialysis (hemodialysis vs. peritoneal dialysis). Protein needs can vary, so it is essential to follow the specific dietary recommendations provided by a healthcare provider.
F.   Avoiding nephrotoxic substances (e.g., certain medications, contrast dyes) is critical to protect the remaining kidney function and prevent further damage.
G.   A low-sodium diet helps manage blood pressure and fluid balance, reducing the risk of fluid retention and hypertension in dialysis patients.

H.   Monitoring urine output is important to assess kidney function and fluid balance.

Even though dialysis takes over some kidney functions, any remaining urine output can provide valuable information about the patient's residual kidney function.

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Correct Answer is {"dropdown-group-1":"A","dropdown-group-2":"B"}

Explanation

Bleeding: The client's platelet count has dropped from 160,000/mm³ to 100,000/mm³, which is below the normal range (150,000 to 400,000/mm³). Platelets are essential for blood clotting, and a low count increases the risk of bleeding. Additionally, the prolonged PT (13.5 seconds) and elevated INR (2.2) further indicate a tendency toward bleeding.

Infection: The client's WBC count remains elevated at 15,500/mm³, which can be indicative of ongoing infection or inflammation. Patients with acute leukemia often have dysfunctional white blood cells, which impairs their ability to fight infections effectively.

A. "The pain occurs as a residual pain from cholecystitis." B. "The pain results from lying in one position too long during surgery." C. "The pain is caused from the nitrous dioxide injected into the abdomen." D. "The pain will dissipate if you ambulate frequently."

Correct Answer is D

Explanation

A. Postoperative pain typically resolves after a laparoscopic cholecystectomy since the surgery removes the gallbladder
B. While positioning during surgery can cause discomfort, isolated right shoulder pain is more commonly attributed to the diaphragmatic irritation from residual nitrous oxide in the abdomen.

C. Nitrous dioxide used during laparoscopic procedures is not associated with referred pain to the right shoulder. The pain is due to carbon dioxide gas used during the procedure resulting in the irritation of the diaphragm.
D. This pain is often due to the carbon dioxide used to inflate the abdomen during surgery, which can irritate the diaphragm and refer pain to the shoulder. Ambulation helps to absorb the gas more quickly.

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The nurse is caring for a 32-year-old female patient coming to the clinic with peripheral edema, periorbital edema, and flank pain. Use the chart to answer the questions. Exhibits Which items should the nurse include when teaching the patient and family about dialysis? Select all that apply.

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is reviewing the medical record for a client who has acute leukemia Exhibits Select words from the choices to fill in each blank in the following sentence The client is at risk for developing and

Correct Answer is {"dropdown-group-1":"A","dropdown-group-2":"B"}

Explanation

A nurse is reinforcing teaching with a client who reports right shoulder pain following a laparoscopic cholecystectomy. Which of the following statements should the nurse make?

Correct Answer is D

Explanation

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The nurse is caring for a 32-year-old female patient coming to the clinic with peripheral edema, periorbital edema, and flank pain. Use the chart to answer the questions.

Exhibits

Which items should the nurse include when teaching the patient and family about dialysis? Select all that apply.