A client is undergoing hemodialysis. The client's blood pressure at the beginning of the procedure was 136/88 mm Hg, and now it is 110/54 mm Hg. What actions would the nurse perform to maintain blood pressure? (Select all that apply.)

Contact the primary health care provider.

Place the patient in the Trendelenburg position.

Administer a 250-ml, bolus of normal saline.

Adjust the rate of extracorporeal blood flow.

Stop the hemodialysis treatment.

Answer and Explanation

Correct Answer : A,B,C,D

Rationale:
A. The nurse should contact the primary health care provider to report the drop in blood pressure during hemodialysis. The provider may need to adjust ultrafiltration goals or fluid removal rates to stabilize the client.
B. Placing the client in the Trendelenburg position (head lower than the feet) helps increase venous return and improve perfusion to vital organs during hypotension. This is an appropriate immediate nursing intervention.
C. Administering a 250-mL bolus of normal saline helps restore circulating blood volume, counteracting the hypovolemia that can occur from excessive fluid removal during dialysis.
D. The nurse can adjust the rate of extracorporeal blood flow or ultrafiltration rate according to facility protocol and provider guidance to reduce the amount of fluid being removed, helping stabilize blood pressure.
E. Stopping hemodialysis abruptly is not the first-line intervention unless the client shows severe instability or unresponsiveness. The priority is to correct hypotension and stabilize the client while continuing dialysis if possible.

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Correct Answer is D

Explanation

Rationale:
A. While abdominal pain may occur with peritonitis, it is a later sign that appears after infection has already developed. The goal is to detect peritonitis at its earliest stage to prevent complications.

B. A fever may occur as peritonitis progresses, but it is not an early indicator. Relying solely on temperature changes may delay recognition of the infection.

C. General malaise is a nonspecific symptom that can occur with many conditions. It does not provide an early or definitive indication of peritonitis.

D. The earliest and most reliable sign of peritonitis in clients receiving peritoneal dialysis is cloudy or opaque dialysate effluent. The cloudiness results from the presence of white blood cells and bacteria in the dialysate, signaling infection in the peritoneal cavity. Prompt reporting and treatment can prevent severe complications.

A. The client's blood pressure is 152/88 mm Hg. B. The client lost 11 lb (5 kg) in the past 10 days. C. No blood is observed in the client's urine. D. The client's urine specific gravity is 1.048.

Correct Answer is C

Explanation

Rationale:
A. A blood pressure of 152/88 mm Hg indicates persistent hypertension, which is a common complication of glomerulonephritis. This finding suggests that the condition has not fully resolved and that further management is needed to control blood pressure.

B. Losing 11 lb (5 kg) in 10 days could indicate fluid loss from diuretic therapy, but such a rapid weight reduction may also point to excessive fluid removal or malnutrition. While it might show some improvement in fluid overload, it is not the best indicator of recovery from glomerulonephritis.

C. Absence of blood in the urine is a positive sign of improvement. Hematuria is a hallmark symptom of glomerulonephritis caused by inflammation and damage to the glomeruli. Resolution of hematuria indicates decreased inflammation and improved kidney function, showing that the treatment is effective.

D. A urine specific gravity of 1.048 is abnormally high, suggesting concentrated urine due to fluid deficit or impaired kidney function. This finding does not reflect improvement and may indicate ongoing renal compromise.

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A client is undergoing hemodialysis. The client's blood pressure at the beginning of the procedure was 136/88 mm Hg, and now it is 110/54 mm Hg. What actions would the nurse perform to maintain blood pressure? (Select all that apply.)

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Naxlex Comprehensive Predictor Exams

The nurse is teaching a patient about performing peritoneal dialysis (PD) at home. In order to identify the earliest manifestation of peritonitis, what does the nurse instruct the patient to do?

Correct Answer is D

Explanation

A nurse evaluates a client with acute glomerulonephritis (GN). Which assessment finding would the nurse recognize as a positive response to the prescribed treatment?

Correct Answer is C

Explanation

A marathon runner comes into the clinic and states "I have not urinated very much in the last few days." The nurse notes a heart rate of 110 beats/min and a blood pressure of 86/58 mm Hg. Which action by the nurse is most appropriate?

A nurse is delegating client care assignments for the shift. Which of the following tasks should the nurse delegate to an assistive personnel (AP)?

After teaching a client with hypertension secondary to renal disease, the nurse assesses the client's understanding. Which statement made by the client indicates a need for additional teaching?

A nurse is teaching a client who has chronic kidney failure about planning a low-protein diet. The client states, "Why do I have to be concerned about protein?" Which of the following responses should the nurse make?

A client is undergoing hemodialysis. The client's blood pressure at the beginning of the procedure was 136/88 mm Hg, and now it is 110/54 mm Hg. What actions would the nurse perform to maintain blood pressure? (Select all that apply.)

A client is having a peritoneal dialysis treatment. The nurse notes an opaque color to the effluent. What is the priority action by the nurse?