The nurse is teaching a patient who is scheduled for hemodialysis about the process and potential complications. Which of the following statements by the patient indicates to the nurse the need for further teaching? (Select All That Apply)

"I can eat any foods I want before dialysis as long as I don't drink too much fluid."

"I need to report any unusual changes in my access site, like redness or swelling."

"I will need to check my blood pressure regularly to monitor for changes during dialysis."

"I should contact my healthcare provider if I notice swelling in my hands, feet, or ankles."

"I understand that hemodialysis will permanently cure my kidney disease."

Answer and Explanation

Correct Answer : A,E

Choice A reason: Eating any foods before dialysis as long as fluid intake is limited is incorrect. Patients undergoing hemodialysis need to follow specific dietary restrictions to manage electrolyte balance and prevent complications. A renal diet typically limits potassium, phosphorus, and sodium intake, in addition to fluid restrictions.

Choice B reason: Reporting any unusual changes in the access site, like redness or swelling, is correct. Changes at the access site can indicate infection or other complications and require immediate attention.

Choice C reason: Checking blood pressure regularly to monitor for changes during dialysis is correct. Blood pressure monitoring is essential during dialysis to detect hypotension or hypertension and adjust treatment accordingly.

Choice D reason: Contacting the healthcare provider if swelling in hands, feet, or ankles is noticed is correct. Swelling can indicate fluid overload or other complications that need to be addressed.

Choice E reason: Understanding that hemodialysis will permanently cure kidney disease is incorrect. Hemodialysis is a treatment that replaces kidney function but does not cure kidney disease. It manages symptoms and removes waste products from the blood.

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Correct Answer is B

Explanation

Choice A reason: Acute hemolytic reactions are severe and typically present with symptoms such as fever, chills, flank pain, hemoglobinuria, and shock. The patient's mild symptoms of itching and a localized rash do not match the severe presentation of an acute hemolytic reaction.

Choice B reason: Allergic reactions to blood transfusions are common and usually present with symptoms such as itching, hives, and localized rash. The patient's vital signs and physical assessment showing mild itching and a rash on the arms are consistent with an allergic reaction.

Choice C reason: Anaphylactic reactions are severe allergic reactions that involve respiratory distress, hypotension, and shock. The patient's mild symptoms do not indicate an anaphylactic reaction.

Choice D reason: Circulatory overload presents with symptoms such as dyspnea, orthopnea, hypertension, and pulmonary edema. The patient's symptoms of itching and a rash do not align with circulatory overload.

A. Encourage the patient to rest in bed for most of the day. B. Administer a high-protein diet including caffeinated beverages to increase energy levels. C. Assist the patient with activities of daily living (ADLs) and encourage frequent rest periods. D. Provide supplemental oxygen via face mask during vigorous exercises.

Correct Answer is C

Explanation

Choice A reason: Encouraging the patient to rest in bed for most of the day may lead to further deconditioning and muscle weakness. While rest is important, balancing activity and rest is more beneficial for managing fatigue in chronic anemia.

Choice B reason: Administering a high-protein diet including caffeinated beverages to increase energy levels is not recommended. While a high-protein diet can support energy and muscle strength, caffeine may cause jitteriness and disrupt sleep, which can exacerbate fatigue.

Choice C reason: Assisting the patient with ADLs and encouraging frequent rest periods is appropriate for managing fatigue, weakness, and activity intolerance in chronic anemia. This approach helps the patient conserve energy while maintaining some level of activity to prevent deconditioning.

Choice D reason: Providing supplemental oxygen via face mask during vigorous exercises is not appropriate. Patients with chronic anemia should avoid vigorous exercises that could exacerbate fatigue and weakness. The focus should be on moderate, manageable activities with adequate rest.

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The nurse is teaching a patient who is scheduled for hemodialysis about the process and potential complications. Which of the following statements by the patient indicates to the nurse the need for further teaching? (Select All That Apply)

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