Which laboratory results should the nurse closely monitor in a client who has end-stage renal disease (ESRD)?

Serum potassium, calcium, and phosphorus.

Erythrocytes, hemoglobin, and hematocrit.

Leukocytes, neutrophils, and thyroxine.

Blood pressure, heart rate, and temperature.

Answer and Explanation

The Correct Answer is A

A. Serum potassium, calcium, and phosphorus: Correct! In end-stage renal disease (ESRD), the kidneys are unable to adequately filter waste products and maintain electrolyte balance.
Monitoring serum potassium, calcium, and phosphorus levels is crucial as imbalances in these
electrolytes are common and can lead to serious complications such as cardiac arrhythmias, bone disorders, and muscle weakness.
B. Erythrocytes, hemoglobin, and hematocrit: While anemia is a common complication of ESRD, monitoring erythrocyte indices (such as erythrocyte count, hemoglobin, and hematocrit) is
important, but it is not specifically related to renal function monitoring.

C. Leukocytes, neutrophils, and thyroxine: Monitoring leukocytes and neutrophils is important for assessing immune function and detecting infections, but it is not directly related to renal
function monitoring in ESRD Thyroxine monitoring is relevant for thyroid function, which is not typically affected by ESRD.
D. Blood pressure, heart rate, and temperature: Monitoring vital signs such as blood pressure,

heart rate, and temperature is important in overall client assessment, but it does not specifically address the need for monitoring electrolyte imbalances associated with ESRD These parameters may be affected by complications of ESRD, but the primary focus in ESRD monitoring is on
renal function and electrolyte balance.

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Correct Answer is C

Explanation

A. A 16-year-old client diagnosed with major depression who refuses to participate in group:

While refusal to participate may warrant assessment and intervention, it does not indicate immediate danger or escalation.

B. A 17-year-old client diagnosed with bipolar disorder who is pacing around the lobby: Pacing behavior may indicate anxiety or agitation, but it does not necessarily require immediate attention unless there are signs of escalating behavior or safety concerns.

C. An 18-year-old client with antisocial behavior who is being yelled at by other clients: Correct! The client with antisocial behavior being yelled at by other clients indicates a potential conflict or safety issue that requires immediate intervention to prevent escalation or harm to the client or others.

D. A 14-year-old client with anorexia nervosa who is refusing to eat the evening snack: Refusal to eat is concerning in a client with anorexia nervosa, but it does not pose an immediate threat to safety compared to the situation involving potential conflict or aggression.

A. The client's need for pain medication should be determined. B. The nurse manager should be updated on the client's status C. The client's status should be conveyed to the chaplain. D. The impending signs of death should be documented

Correct Answer is A

Explanation

A. Determining the client's need for pain medication is a priority to ensure comfort and manage symptoms as the client approaches end of life.
B. Updating the nurse manager on the client's status is important, but it is not the priority action in terms of direct client care.
C. Conveying the client's status to the chaplain may be part of holistic care, but the immediate physical needs of the client take precedence.
D. Documenting the impending signs of death is essential for medical records, but addressing the client's comfort needs is the priority.

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Which laboratory results should the nurse closely monitor in a client who has end-stage renal disease (ESRD)?

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