A client on peritoneal dialysis has a prescription for hypertonic dialysate. Which of the following findings should the nurse expect during the infusion of hypertonic dialysate?
Increased fluid removal
Decreased urine output
Hydration overload
Hypotension
The Correct Answer is A
A) This statement is accurate. Hypertonic dialysate has a higher concentration of glucose, which results in increased fluid removal from the client's peritoneal cavity. This type of dialysate is often used for more effective ultrafiltration.
B) This statement is incorrect. Infusing hypertonic dialysate does not result in decreased urine output. Peritoneal dialysis is a process of exchanging fluids and waste products through the peritoneal membrane, but it does not directly affect urine production.
C) This statement is incorrect. Infusing hypertonic dialysate would not lead to hydration overload, as it causes fluid to be removed from the body.
D) This statement is incorrect. Hypertonic dialysate would not cause hypotension. In fact, it may lead to a decrease in blood pressure due to fluid removal, but it would not be considered a primary cause of hypotension.
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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.
Correct Answer is B
Explanation
A) This statement is incorrect. Increasing the intake of potassium-rich foods is not related to managing constipation. In fact, clients on peritoneal dialysis may need to restrict potassium intake due to the potential for electrolyte imbalances.
B) This statement is accurate. Constipation can be a common issue for clients on peritoneal dialysis due to the presence of glucose in the dialysate, which can draw fluid into the peritoneal cavity and lead to decreased bowel movement. Administering a stool softener as needed can help alleviate constipation.
C) This statement is incorrect. Decreasing fluid intake during dialysis is not recommended for managing constipation. Fluid intake should be maintained as prescribed to achieve adequate ultrafiltration.
D) This statement is incorrect. Encouraging the client to consume dairy products is not directly related to managing constipation. While calcium intake may be important for bone health in clients with ESRD, it is not a primary intervention for constipation.
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