A client with chronic kidney disease (CKD) is experiencing severe metabolic acidosis, which is not responding to medical management. Which of the following is the primary indication for initiating dialysis in this client?

Hypernatremia

Hyperkalemia

Hypocalcemia

Severe metabolic acidosis

Answer and Explanation

The Correct Answer is D

A) This statement is incorrect. Hypernatremia (high sodium levels) is not the primary indication for initiating dialysis in this case. Metabolic acidosis and the inability of the kidneys to excrete acids are the primary concerns.

B) This statement is incorrect. Hyperkalemia (elevated potassium levels) may occur in CKD, but it is not the primary indication described in the scenario. Metabolic acidosis is the primary concern leading to the need for dialysis.

C) This statement is incorrect. Hypocalcemia (low calcium levels) can be a complication of CKD, but it is not the primary indication for initiating dialysis in this scenario. Metabolic acidosis and its associated symptoms take precedence.

D) Severe metabolic acidosis, which results from the kidneys' inability to adequately excrete acids and regulate pH balance, is a critical indication for initiating dialysis in clients with CKD.

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Correct Answer is A

Explanation

A) This statement is incorrect. Increasing the dialysis session duration would not address the client's muscle cramps and may lead to further fluid and electrolyte imbalances.

B) Muscle cramps during hemodialysis can be caused by the cooling effect of the dialysate solution. Increasing the temperature of the dialysate can help alleviate the cramps.

C) This statement is incorrect. Decreasing the dialysate solution flow rate may not directly address the muscle cramps and may not be indicated unless there are other clinical indications to do so.

D) This statement is incorrect. Administering an anticoagulant medication is not relevant to address muscle cramps. Muscle cramps during hemodialysis are often caused by the cooling effect of the dialysate solution. Increasing the temperature of the dialysate can help alleviate the cramps.

A. Increase the rate of fluid removal during dialysis. B. Administer an antihypertensive medication. C. Assess the client's blood pressure and pulse rate. D. Elevate the client's legs to promote blood flow.

Correct Answer is C

Explanation

A) This statement is incorrect. Increasing the rate of fluid removal during dialysis may worsen the client's symptoms of lightheadedness and dizziness, as it can lead to further drops in blood pressure.

B) This statement is incorrect. Administering an antihypertensive medication is not appropriate in this situation, as the client is experiencing symptoms of low blood pressure, not high blood pressure.

C) This statement is accurate. Feeling lightheaded and dizzy during hemodialysis may be a sign of hypotension (low blood pressure), and the nurse should assess the client's blood pressure and pulse rate to determine if intervention is needed.

D) This statement is incorrect. Elevating the client's legs may promote blood flow, but it does not address the immediate issue of lightheadedness and dizziness. Assessing the client's blood pressure and pulse rate is the priority to determine the appropriate intervention.

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A client with chronic kidney disease (CKD) is experiencing severe metabolic acidosis, which is not responding to medical management. Which of the following is the primary indication for initiating dialysis in this client?

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Naxlex Comprehensive Predictor Exams

A nurse is caring for a client on hemodialysis who is experiencing muscle cramps during the procedure. Which intervention should the nurse implement?

Correct Answer is A

Explanation

A client on hemodialysis reports feeling lightheaded and dizzy during the procedure. Which of the following actions should the nurse take first?

Correct Answer is C

Explanation

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