A client with a right hemisphere stroke is eating lunch.
The nurse notes the client is only eating food from the right side of the tray and is unaware of food remaining on the left side. What is the nurse's priority action?

Hemodialysis is a renal replacement therapy used to remove metabolic waste and excess fluid. Evaluating its effectiveness requires applying knowledge of solute clearance and normal laboratory values to determine if the procedure successfully filtered toxins from the patient's blood.

Choice A rationale

The primary goal of hemodialysis is to remove nitrogenous waste products like urea. A decrease in Blood Urea Nitrogen (BUN) from elevated levels toward the normal range of 10 to 20 mg/dL indicates successful solute clearance.

Choice B rationale

Hemodialysis is designed to filter small solutes and water, not to significantly decrease the white blood cell count. A normal WBC count ranges from 5,000 to 10,000/mm. A decrease is not an expected or desired dialysis outcome.

Choice C rationale

Patients with renal failure often have low calcium. Hemodialysis typically uses a dialysate containing calcium to help normalize levels toward 9.0 to 10.5 mg/dL. A decrease in calcium is generally an adverse finding, not a therapeutic goal.

Choice D rationale

Hemodialysis does not aim to decrease red blood cell counts. Patients with chronic kidney disease often have anemia due to low erythropoietin. A decrease in RBCs would be an undesirable complication rather than a measure of effectiveness.

Determining priority assessments in hospice care requires applying Maslow's hierarchy and the nursing process. Understanding the medical diagnosis is foundational for anticipating physical needs, managing symptoms, and ensuring safety, which precedes addressing psychosocial, spiritual, or financial concerns during the initial admission phase.

Choice A rationale

Identifying the medical diagnosis is essential for clinical decision making and symptom management. It allows the nurse to anticipate complications, understand prognosis, and provide appropriate pharmacological interventions to ensure comfort, which is the primary goal of hospice.

Choice B rationale

While financial stability affects long term care planning, it is not the immediate clinical priority upon admission. Basic physiological needs and medical stability must be addressed before the nurse evaluates the client's insurance coverage or socioeconomic status.

Choice C rationale

Spiritual assessment is a core component of holistic hospice care, yet it follows physical stabilization. The nurse must first ensure the client is not in acute physical distress before exploring religious beliefs or existential concerns.

Choice D rationale

Assessing the support system is vital for planning home care and caregiver respite. However, without understanding the medical condition first, the nurse cannot accurately determine the level of support or specific skills the family needs.