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Clinical Features and Complications

- ESRD affects multiple organ systems and leads to various signs and symptoms such as:

- Fluid and electrolyte imbalances: edema, hypertension, dysrhythmias, hyperkalemia, hyponatremia, hypocalcemia, hyperphosphatemia, metabolic acidosis.

- Hematologic disorders: anemia, bleeding tendencies, infection risk.

- Cardiovascular disorders: heart failure, coronary artery disease, pericarditis, peripheral vascular disease.

- Respiratory disorders: pulmonary edema, pleural effusion, uremic pneumonitis.

- Gastrointestinal disorders: nausea, vomiting, anorexia, gastritis, peptic ulcer disease, constipation.

- Neurologic disorders: encephalopathy, neuropathy, seizures, coma.

- Musculoskeletal disorders: renal osteodystrophy, bone pain, fractures.

- Endocrine disorders: insulin resistance, hyperglycemia, hyperlipidemia.

- Dermatologic disorders: pruritus, uremic frost.

- Reproductive disorders: infertility, impotence.

Questions on Clinical Features and Complications

Correct Answer is B

Explanation

This is incorrect because ESRD is not a condition where the kidneys can recover with proper management. Once the kidneys have reached end-stage, their ability to function is permanently compromised.

Correct Answer is B

Explanation

This is incorrect because ESRD is a severe condition where the kidneys have permanently lost their ability to function, and treatment options such as dialysis or transplantation are necessary to sustain life.

Correct Answer is A

Explanation

This is incorrect because high blood pressure (hypertension) is a significant risk factor for the development and progression of ESRD. Uncontrolled hypertension can lead to damage to the blood vessels in the kidneys, contributing to kidney disease.

Correct Answer is B

Explanation

This is correct. Consuming foods low in phosphorus is crucial for clients with ESRD. High phosphorus levels can lead to complications such as bone disease, so managing phosphorus intake is essential.

Correct Answer is A

Explanation

This is incorrect. Hemodialysis does not involve surgical replacement of damaged kidneys. It is a non-surgical procedure performed in a dialysis center using a dialysis machine.

Correct Answer is B

Explanation

This is incorrect. While peritoneal dialysis does carry some risk of infection, it is generally considered to have a lower risk of infection compared to hemodialysis, where blood is exposed to an external machine.

Correct Answer is D

Explanation

This is correct. Kidney transplantation offers the best chance for long-term survival and eliminates the need for ongoing dialysis. It provides improved quality of life and potential freedom from dietary restrictions, fluid restrictions, and the time-consuming dialysis procedure.Questions

Correct Answer is B

Explanation

This is incorrect. While genetic factors and family history may play a role in some cases of kidney disease, they are not the primary causes of ESRD. ESRD is most commonly associated with chronic conditions like diabetes and hypertension.

Correct Answer is B

Explanation

This is incorrect. High-intensity exercise may not be suitable for all individuals with kidney disease, and the client should consult their healthcare provider before engaging in any exercise program. While regular physical activity can be beneficial for overall health, the type and intensity of exercise should be individualized based on the client's medical condition and fitness level.

Correct Answer is A

Explanation

This is incorrect. PKD is not caused by chronic kidney infections; it is a genetic condition that results in the formation of cysts within the kidney tissue.

Correct Answer is D

Explanation

This statement requires further evaluation by the nurse. While hypertension and diabetes are well-known risk factors for ESRD, the absence of kidney stones does not rule out other potential causes or risk factors for the client's current diagnosis.

Correct Answer is A

Explanation

This is incorrect. Smoking and regular alcohol consumption can have harmful effects on the kidneys and overall health. Smoking is a risk factor for kidney disease progression, and excessive alcohol consumption can contribute to high blood pressure and other health issues that may worsen kidney function.

Correct Answer is C

Explanation

This is incorrect. While having a family history of gout can be associated with an increased risk of kidney stones and kidney damage, it is not a common risk factor for the development of ESRD.

Correct Answer is B

Explanation

This is incorrect. Herbal supplements should not be considered as replacements for prescribed medications in managing ESRD. The client should always consult with their healthcare provider before starting or continuing the use of herbal supplements to ensure they are safe and appropriate for their medical condition.Questions

Correct Answer is B

Explanation

This is incorrect. ESRD is often associated with hypertension and other cardiovascular complications. Clients with ESRD may experience symptoms such as high blood pressure, shortness of breath, and chest pain.

Correct Answer is C

Explanation

This is not the priority assessment for this client. While increased blood pressure can be a complication of ESRD, decreased urine output takes precedence in this situation.

Correct Answer is A

Explanation

This is incorrect. ESRD can affect the gastrointestinal system, leading to complications such as nausea, vomiting, and gastrointestinal bleeding due to the accumulation of waste products and electrolyte imbalances.

Correct Answer is C

Explanation

This is incorrect. While dietary protein intake may need to be adjusted for clients with ESRD, restricting protein intake to minimal levels can lead to malnutrition and other complications. It is not an appropriate intervention for muscle cramps and twitching.

Correct Answer is A

Explanation

This is incorrect. Hemodialysis is used to regulate potassium levels in clients with ESRD, as high potassium levels can be dangerous. It is more common for potassium levels to be reduced during hemodialysis, not increased.

Correct Answer is D

Explanation

This statement is incorrect. There is no evidence to suggest that clients on ESA therapy should avoid vaccinations. In fact, vaccination is important for clients with ESRD to protect against infections, which can be particularly dangerous for individuals with compromised kidney function.

Correct Answer is A

Explanation

This is incorrect. Impaired respiratory function and lung collapse are not typical complications of peritoneal dialysis. These are more commonly associated with other respiratory conditions and not directly related to peritoneal dialysis.Questions

Correct Answer is B

Explanation

This statement is incorrect. Dialysis is not a medication-based treatment; it is a mechanical process to cleanse the blood outside the body.

Correct Answer is A

Explanation

This statement is incorrect. Dialysis is a common and effective treatment option for ESRD when kidney function has significantly declined. It can improve the quality of life and extend survival for many clients with ESRD.

Correct Answer is C

Explanation

This is incorrect. Electrolyte imbalances and fluid overload can occur with both peritoneal dialysis and hemodialysis. However, peritonitis is a specific complication unique to peritoneal dialysis.

Correct Answer is D

Explanation

This is correct. Hypotension and low blood pressure are common complications of hemodialysis. During the procedure, the rapid removal of fluids can cause a drop in blood pressure, leading to symptoms such as dizziness and lightheadedness.

This is incorrect. Increasing fluid intake during dialysis may not be appropriate, as the goal of hemodialysis is to remove excess fluids from the body. Encouraging increased fluid intake could lead to fluid overload and worsen the client's symptoms.

This is incorrect. The catheter should remain connected to the drainage bag at all times, even during sleep. Disconnecting the catheter can disrupt the dialysate exchange process and increase the risk of infection and other complications.

This is not directly related to home-based peritoneal dialysis. While proximity to a local hospital or medical facility is always important for any client, it is not a primary factor for choosing home-based peritoneal dialysis as a treatment option.Questions

<p>This statement is incorrect. Renal transplantation is not limited to clients with a specific genetic predisposition; it is a treatment option considered for any eligible client with ESRD.</p>

<p>This statement is incorrect. While genetic matching can be considered in living donor scenarios, it does not apply to deceased donor situations.</p>

<p>This statement is incorrect. Blood type compatibility is essential for a successful transplant, but it is not the only consideration in the evaluation process for living donors.</p>

<p>This statement is incorrect. The donor&#39;s kidney is typically transplanted into the lower abdomen on the opposite side from the recipient&#39;s native failed kidney to ensure proper blood supply and surgical access.</p>

This statement is incorrect. Immunosuppressive medications are not intended to improve the function of native kidneys. Their primary purpose is to prevent rejection of the transplanted kidney.

This statement is incorrect. Preemptive transplantation is considered as an option for eligible candidates who have ESRD but have not yet started dialysis.

This statement is important to address, but it is not the highest priority. Short-term complications related to immunosuppressive medications can be managed, and the benefits of preventing graft rejection outweigh the risks associated with these medications.Questions

This response is not supportive. Encouraging the client to talk less to their family about their feelings can lead to feelings of isolation and may hinder the client from seeking the support they need.

This intervention is not appropriate. Encouraging the client to focus solely on the physical benefits of dialysis ignores the emotional impact of the treatment and does not address the client's feelings of anger and frustration.

This option is not appropriate. Encouraging the client to stop discussing their concerns with family members can isolate the client emotionally and prevent them from receiving much-needed emotional support.

This response is not appropriate. Encouraging the client to rely more on friends than family for support may not be practical or address the client's feelings of guilt and burden.

This statement is correct. Clients with ESRD have impaired kidney function, which can lead to decreased potassium excretion. Excess potassium in the bloodstream can result in dangerous heart rhythm disturbances (arrhythmias) and muscle weakness. Limiting dietary potassium helps prevent these complic

This statement is incorrect. Iron supplements are not specifically used to prevent dangerous blood clots.

This statement is correct. In clients with ESRD, impaired kidney function can lead to increased phosphorus levels in the blood (hyperphosphatemiA. . Phosphate binders are prescribed to lower the absorption of dietary phosphorus, thus reducing the phosphorus level in the blood. Maintaining appropriat

While it is essential to reassure the client that feeling overwhelmed is normal, attending a support group can provide them with practical strategies for coping with these emotions.

Encouraging the client to think about positive aspects and avoid dwelling on the negative may not allow the client to process and express their feelings genuinely.

Encouraging the client to rely solely on family for emotional support may not be sufficient to address the severity of their emotional concerns. Professional counseling and therapy are necessary to address clinical depression.

While physical activity is essential for overall health, excessive physical activity may not address the root cause of stress and can lead to physical exhaustion.

While it may be true that financial struggles are common in ESRD, simply acknowledging this fact does not offer practical solutions or support to the client in managing their financial difficulties.

Advising the client to avoid monitoring their fluid and dietary intake can lead to fluid overload and worsen their ESRD condition.

This is the correct answer. Listening to the client's concerns and exploring strategies together allows the nurse to identify potential barriers to adherence and develop personalized solutions that are meaningful to the client. Collaborative goal-setting enhances the client's motivation and promotes
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