A client on peritoneal dialysis 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 peritoneal dialysis. 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 peritoneal dialysis 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 D

Explanation

A) This statement is incorrect. Hypercalcemia (elevated calcium levels) can be a concern in ESRD, but it is not the primary indication for initiating dialysis in this scenario. Pruritus is more commonly associated with uremia and high levels of other waste products.

B) This statement is incorrect. Hypervolemia (fluid overload) can be a concern in ESRD, but it is not the primary indication described in the scenario. The persistent pruritus is more likely related to uremia and the accumulation of toxins.

C) This statement is incorrect. Hyperkalemia (elevated potassium levels) is not the primary indication described in the scenario. While hyperkalemia may occur in ESRD, the primary concern leading to the need for dialysis in this case is the uremia and its associated symptoms.

D) Uremia, which is the accumulation of urea and other waste products in the blood, can lead to various complications, including pruritus. Dialysis helps remove these waste products from the bloodstream and may alleviate the itching associated with uremia.

A. Increase the dialysis session duration. B. Increase the dialysate solution temperature. C. Decrease the dialysate solution flow rate. D. Administer an anticoagulant medication. E. None F. None

Correct Answer is B

Explanation

A. Increase the dialysis session duration: Extending the session may help reduce fluid shifts over time, but it is not an immediate intervention to relieve acute muscle cramps during dialysis.
B. Increase the dialysate solution temperature: Warming the dialysate can improve muscle perfusion and reduce the incidence of cramping during dialysis. It helps minimize vasoconstriction and discomfort.
C. Decrease the dialysate solution flow rate: This is not typically used to treat muscle cramps. Flow rate adjustments affect solute clearance and may not alleviate cramping.
D. Administer an anticoagulant medication: Anticoagulants are used to prevent clotting in the dialysis circuit and do not treat or prevent muscle cramps.

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A client on peritoneal dialysis 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 client with end-stage renal disease (ESRD) has been experiencing persistent pruritus (itching) that is not responding to conservative management. Which of the following is the primary indication for initiating dialysis in this client?

Correct Answer is D

Explanation

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Correct Answer is B

Explanation

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