The physician prescribes ticarcillin 35 mg IV every 4 hours for a client post kidney transplant.

The client weighs 14 lbs.

The nursing drug reference recommends a maximum of 20-30 mg/kg/day.

Is the ordered dose for this client safe? Yes or No.

Hemodialysis is a renal replacement therapy used to remove metabolic waste and excess fluid. Evaluating its effectiveness requires applying knowledge of solute clearance and normal laboratory values to determine if the procedure successfully filtered toxins from the patient's blood.

Choice A rationale

The primary goal of hemodialysis is to remove nitrogenous waste products like urea. A decrease in Blood Urea Nitrogen (BUN) from elevated levels toward the normal range of 10 to 20 mg/dL indicates successful solute clearance.

Choice B rationale

Hemodialysis is designed to filter small solutes and water, not to significantly decrease the white blood cell count. A normal WBC count ranges from 5,000 to 10,000/mm. A decrease is not an expected or desired dialysis outcome.

Choice C rationale

Patients with renal failure often have low calcium. Hemodialysis typically uses a dialysate containing calcium to help normalize levels toward 9.0 to 10.5 mg/dL. A decrease in calcium is generally an adverse finding, not a therapeutic goal.

Choice D rationale

Hemodialysis does not aim to decrease red blood cell counts. Patients with chronic kidney disease often have anemia due to low erythropoietin. A decrease in RBCs would be an undesirable complication rather than a measure of effectiveness.

The scenario requires applying family systems theory and interdisciplinary communication principles within hospice care. Effective coping begins by clarifying the support structure available to the family, necessitating an understanding of how various professional roles function to alleviate the burden of end of life care.

Choice A rationale

Planning for hospital readmission contradicts the primary goal of hospice, which focuses on maintaining a comfortable home death. Focusing on hospitalization initially can create anxiety and undermine the family's confidence in managing the client's care at home.

Choice B rationale

Hospice typically provides intermittent visits rather than continuous 24-hour home care. Suggesting the nurse will meet all daily basic needs is unrealistic and provides false expectations, which can negatively impact the family's long-term ability to cope with caregiving.

Choice C rationale

While bereavement support is a standard component of hospice services, discussing post-death visits during the initial assessment is premature. Families need immediate support strategies and role clarity to manage the active dying process before focusing on aftercare services.

Choice D rationale

Clarifying the roles of the interdisciplinary team empowers the family by identifying specific resources for physical, emotional, and spiritual needs. This foundational knowledge reduces uncertainty, establishes a support network, and is the essential first step in facilitating effective coping.