A client with acute kidney injury is receiving hemodialysis.
Which of the following interventions should the nurse prioritize during the dialysis treatment?
Monitoring the client's blood pressure every 4 hours.
Administering a loop diuretic before the treatment.
Assessing the client's respiratory status every 2 hours.
Monitoring the client's electrolyte levels before and after the treatment.
Monitoring the client's electrolyte levels before and after the treatment.
The Correct Answer is D
Monitoring the client’s electrolyte levels before and after the treatment. This is because acute kidney injury (AKI) can cause electrolyte imbalances such as hyperkalemia, hyperphosphatemia, hypocalcemia, and metabolic acidosis. Hemodialysis can help correct these imbalances by removing excess fluid and waste products from the blood. However, hemodialysis can also cause electrolyte shifts and complications such as hypotension, muscle cramps, and arrhythmias. Therefore, it is important to monitor the client’s electrolyte levels before and after the treatment to assess the effectiveness and safety of hemodialysis.
Choice A is wrong because monitoring the client’s blood pressure every 4 hours is not frequent enough during hemodialysis.
Hemodialysis can cause rapid changes in blood pressure due to fluid removal and vascular access.
Therefore, blood pressure should be monitored more often, such as every 15 to 30 minutes during hemodialysis.
Choice B is wrong because administering a loop diuretic before the treatment is not indicated for AKI patients receiving hemodialysis.
Loop diuretics are used to increase urine output and reduce fluid overload in AKI patients who have some residual kidney function.
However, hemodialysis can achieve the same goal by removing excess fluid from the blood.
Moreover, loop diuretics can cause electrolyte depletion and ototoxicity, which can worsen the condition of AKI patients.
Choice C is wrong because assessing the client’s respiratory status every 2 hours is not specific enough for hemodialysis treatment.
Hemodialysis can affect respiratory mechanics by altering fluid balance, acid- base status, and oxygen delivery.
Therefore, respiratory status should be assessed more frequently and comprehensively during hemodialysis, such as by measuring respiratory rate, oxygen saturation, arterial blood gas, and chest auscultation.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Serum creatinine is a waste product that comes from muscle activity and is normally removed by the kidneys.
When the kidneys are damaged, the serum creatinine level rises.
The glomerular filtration rate (GFR) is a measure of how well the kidneys are filtering the blood and it is calculated from the serum creatinine level.
A normal GFR is 60 or more, while a GFR below 60 may indicate kidney disease.
Therefore, monitoring the serum creatinine level and the GFR can help assess the renal function in CKD.
Choice A is wrong because blood glucose level is not a direct indicator of renal function, although high blood glucose can damage the kidneys over time.
Choice C is wrong because serum albumin level is not a specific marker of renal function, although low serum albumin can be caused by protein loss in the urine due to kidney damage.
Choice D is wrong because white blood cell count is not related to renal function, but rather to immune system activity and infection.
Normal ranges for serum creatinine are 0.6 to 1.2 mg/dL for men and 0.5 to 1.1 mg/dL for women.
Normal ranges for GFR are 90 to 120 mL/min.
Normal ranges for serum albumin are 3.4 to 5.4 g/dL1.
Normal ranges for white blood cell count are 4,000 to 11,000 cells per microliter.
Correct Answer is A
Explanation
This is because hemodialysis removes excess fluid and waste products from the blood, but it also removes some electrolytes, such as potassium.
Potassium is important for nerve and muscle function, especially the heart.
If potassium levels are too high or too low, it can cause irregular heartbeat or cardiac arrest.
Choice B is wrong because hypokalemia means low potassium levels, which is unlikely in renal failure unless there is excessive potassium loss from diarrhea, vomiting or diuretics.
Choice C is wrong because hyponatremia means low sodium levels, which can occur in renal failure due to fluid retention, but it is not directly related to hemodialysis.
Choice D is wrong because hypernatremia means high sodium levels, which can occur in renal failure due to reduced urine output, but it is also not directly related to hemodialysis.
Normal ranges for electrolytes are: Potassium: 3.5 to 5.0 mmol/L
Sodium: 135 to 145 mmol/L
Calcium: 8.5 to 10.5 mg/dL
Chloride: 96 to 106 mmol/L
Magnesium: 1.7 to 2.2 mg/dL
Phosphate: 2.5 to 4.5 mg/dL
Bicarbonate: 22 to 29 mmol/L
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