A client is scheduled to receive peritoneal dialysis. Which of the following is the highest priority action that the nurse should perform before starting dialysis?
Weigh the client
Place the client in high Fowler’s position
Administer pain medications
Place the client in Trendelenburg position
The Correct Answer is A
Choice A reason: Weighing assesses fluid status pre-dialysis, guiding ultrafiltration goals in peritoneal dialysis to remove excess fluid safely, the priority for efficacy and safety.
Choice B reason: High Fowler’s aids breathing but isn’t critical pre-dialysis; semi-Fowler’s is used during, not before, making this secondary to weight assessment.
Choice C reason: Pain medication eases discomfort during dialysis but isn’t the priority; weight determines fluid removal needs first, ensuring treatment accuracy.
Choice D reason: Trendelenburg position aids hypotension, not routine pre-dialysis preparation, irrelevant to starting peritoneal dialysis compared to weight’s foundational role.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason: Thyroid cancer involves malignant thyroid growth, not a consequence of parathyroid damage during surgery, which affects calcium, not cancer risk.
Choice B reason: Goiter is thyroid enlargement from iodine issues or hyperplasia, unrelated to parathyroid damage, which controls calcium, not thyroid size.
Choice C reason: Graves’ disease, hyperthyroidism, results from autoantibodies, not parathyroid injury, which causes hypocalcemia, not thyroid hormone excess.
Choice D reason: Parathyroid damage reduces PTH, dropping calcium levels, leading to tetany—muscle spasms from hypocalcemia, a direct surgical complication.
Correct Answer is ["B"]
Explanation
Choice A reason: Calcium carbonate supplements increase serum calcium by providing exogenous calcium, worsening hyperparathyroidism’s already elevated levels from excessive PTH-driven bone resorption and gut absorption.
Choice B reason: A low calcium diet reduces intake, limiting absorption, while high fiber binds calcium in the gut, enhancing fecal excretion, countering PTH’s hypercalcemic effect in hyperparathyroidism.
Choice C reason: Parathyroidectomy removes overactive glands, directly stopping excessive PTH production, which drives calcium release from bones and reabsorption in kidneys, effectively normalizing calcium levels.
Choice D reason: Furosemide, a loop diuretic, increases renal calcium excretion by inhibiting reabsorption in the loop of Henle, reducing serum calcium elevated by PTH in hyperparathyroidism.
Choice E reason: Fluid restriction raises calcium concentration by reducing dilution, worsening hypercalcemia in hyperparathyroidism, where PTH already increases calcium reabsorption, making this counterproductive.
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