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

Answer and Explanation

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.

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Correct Answer is C

Explanation

Choice A reason: Hydroxychloroquine treats autoimmune diseases like lupus by modulating immunity, not hyperthyroidism’s excess thyroid hormone production, irrelevant here.

Choice B reason: Levothyroxine supplements thyroid hormone in hypothyroidism, worsening this patient’s hyperthyroidism (high T3/T4), contraindicated for her symptoms.

Choice C reason: Potassium iodide inhibits thyroid hormone release, reducing T3 and T4 in hyperthyroidism (e.g., Graves’), addressing her goiter, exophthalmos, and weight loss effectively.

Choice D reason: Methotrexate suppresses immunity in cancer or autoimmunity, not targeting thyroid overactivity or hormone levels, unsuitable for hyperthyroidism management.

A. A client with an intestinal obstruction whose nasogastric tube has drained 150 mL in 8 hours B. A client with ascites who has a respiratory rate of 26 and oxygen saturation level of 90% C. A client with acute pancreatitis who has decreased breath sounds with increased crackles D. A client with stable esophageal varices and a blood pressure of 92/45

Correct Answer is C

Explanation

Choice A reason: 150 mL NG drainage in 8 hours is low for obstruction, suggesting stability; it’s less urgent than respiratory compromise in other clients.

Choice B reason: Respiratory rate 26 and 90% saturation indicate distress in ascites, but crackles suggest fluid overload, less acute than pancreatitis’s pulmonary risk.

Choice C reason: Decreased breath sounds and crackles in pancreatitis signal pleural effusion or ARDS, a life-threatening complication, prioritizing immediate respiratory assessment.

Choice D reason: BP 92/45 with stable varices is concerning but not acutely unstable without bleeding signs, less critical than respiratory failure in pancreatitis.

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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?

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Correct Answer is C

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