A client is to have hemodialysis. What must the nurse do before this treatment?

Administer scheduled medications

Explain that dialysis occurs via the peritoneum

Weigh the client to determine a baseline for comparison

Obtain a serum creatinine to determine kidney function

Answer and Explanation

The Correct Answer is C

A. Administer scheduled medications: Some medications (e.g., antihypertensives, water-soluble vitamins, and antibiotics) should be held before dialysis to prevent removal during treatment.

B. Explain that dialysis occurs via the peritoneum: This describes peritoneal dialysis, not hemodialysis.

C. Weigh the client to determine a baseline for comparison: Pre-dialysis weight is crucial to determine fluid removal needs during dialysis. Weight differences before and after dialysis indicate fluid loss or retention.

D. Obtain a serum creatinine to determine kidney function: Serum creatinine levels are monitored regularly but are not a required step before every dialysis session.

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Correct Answer is B

Explanation

A. pH 7.30, PaCO₂ 38, HCO₃ 15: Metabolic acidosis (low HCO₃, normal PaCO₂).

B. pH 7.32, PaCO₂ 56, PO₂ 84, HCO₃ 26: The client has respirations of 8/min, which indicates hypoventilation → CO₂ retention → respiratory acidosis. pH 7.32 indicates acidosis. PaCO₂ 56 mmHg - Elevated CO₂ (hypercapnia), confirming respiratory acidosis. HCO₃ 26- Normal bicarbonate suggests that compensation has not yet occurred

C. pH 7.37, PaCO₂ 45, HCO₃ 24: Normal ABG values.

D. pH 7.48, PaCO₂ 32, HCO₃ 22: Respiratory alkalosis (low PaCO₂ due to hyperventilation, not hypoventilation).

A. Respiratory Acidosis B. Metabolic Alkalosis C. Respiratory Alkalosis D. Metabolic acidosis

Correct Answer is D

Explanation

A. Respiratory Acidosis: Respiratory acidosis results from inadequate ventilation leading to CO₂ retention, which is unrelated to kidney failure.

B. Metabolic Alkalosis: Metabolic alkalosis occurs due to excessive loss of acids (e.g., vomiting) or excess bicarbonate intake. Acute renal failure causes acid retention, not loss.

C. Respiratory Alkalosis: Respiratory alkalosis is caused by hyperventilation and excessive CO₂ loss, not renal dysfunction.

D. Metabolic acidosis: The kidneys play a vital role in acid-base balance by excreting hydrogen ions and reabsorbing bicarbonate. Acute renal failure impairs these functions, leading to acid retention and metabolic acidosis.

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A client is to have hemodialysis. What must the nurse do before this treatment?

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