A client on hemodialysis is prescribed erythropoietin-stimulating agents (ESAs) to manage anemia. Which of the following laboratory values should the nurse monitor closely during ESA therapy?

Serum calcium levels

Blood urea nitrogen (BUN) levels

Hemoglobin and hematocrit levels

Serum potassium levels

Answer and Explanation

The Correct Answer is C

A) This statement is incorrect. Serum calcium levels are not directly related to ESA therapy for anemia management. ESA therapy focuses on increasing red blood cell production.

B) This statement is incorrect. Blood urea nitrogen (BUN) levels are indicators of kidney function and may be monitored for other reasons in a client on hemodialysis. However, they are not directly related to ESA therapy for anemia management.

C) This statement is accurate. During ESA therapy, the nurse should closely monitor the client's hemoglobin and hematocrit levels. ESAs stimulate the production of red blood cells and can increase hemoglobin and hematocrit levels. Regular monitoring is essential to prevent anemia or excessive increases in these values.

D) This statement is incorrect. Serum potassium levels may be monitored for a client on hemodialysis due to the potential for electrolyte imbalances, but they are not the primary concern during ESA therapy for anemia management.

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Correct Answer is C

Explanation

A. Correct. Avoiding heavy lifting can help prevent trauma or dislodgement of the peritoneal catheter, which can be a risk factor for infection or complications.

B. Correct. Cleaning the catheter exit site with soap and water daily helps maintain cleanliness and reduce the risk of infection.

C. Incorrect. The dressing around the catheter insertion site should be changed more frequently than weekly, ideally every 2-3 days, to ensure proper hygiene and reduce the risk of infection.

D. Correct. Notifying the healthcare provider about any redness or drainage at the catheter site is essential, as these can be signs of infection or other complications that require prompt evaluation and treatment.

A. Hypoglycemia B. Hyperkalemia C. Hypernatremia D. Decreased GFR

Correct Answer is D

Explanation

A) This statement is incorrect. Hypoglycemia (low blood glucose) is not the primary indication for initiating dialysis. Hypoglycemia can occur in certain situations, but it is not the primary concern in this case.

B) This statement is incorrect. Hyperkalemia (elevated potassium levels) can be a concern in AKI, but it is not the primary indication described in the scenario. The primary concern in AKI with decreased GFR is the impaired filtration and waste removal, leading to the need for dialysis.

C) This statement is incorrect. Hypernatremia (high sodium levels) is not a primary indication for initiating dialysis in AKI. Hypernatremia is rare in AKI and usually occurs when there is a significant loss of free water compared to sodium intake.

D) A significantly decreased glomerular filtration rate (GFR) indicates that the kidneys' ability to filter waste products and excess fluids from the blood is severely impaired. Dialysis can help support kidney function and remove waste products when the GFR is critically low.

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A client on hemodialysis is prescribed erythropoietin-stimulating agents (ESAs) to manage anemia. Which of the following laboratory values should the nurse monitor closely during ESA therapy?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is providing education to a client undergoing peritoneal dialysis about maintaining good peritoneal catheter care. Which statement by the client indicates a need for further education?

Correct Answer is C

Explanation

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Correct Answer is D

Explanation

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