A client with chronic renal failure has an internal arteriovenous fistula in the left arm for vascular access during hemodialysis. Which of the following is most important to include in the patient teaching? Select all that apply)

Assess fingers on the left arm for warmth

Wear wristwatch on the right arm

Avoid sleeping on the left arm

Remind the health care providers to draw blood from veins on the left side

Obtain blood pressure from the left arm

Answer and Explanation

Correct Answer : A,B,C

A. Monitoring for warmth in the fingers of the left arm is important to assess for proper circulation through the arteriovenous fistula.

B. Wearing a wristwatch on the right arm prevents putting pressure on the left arm, where the fistula is located, which could affect its function.

C. Avoiding sleeping on the left arm helps prevent pressure on the fistula and reduces the risk of complications.

D. Blood should not be drawn from the left arm with the fistula as it could damage the fistula.

E. Blood pressure should not be taken from the left arm to avoid disrupting the fistula's function.

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Correct Answer is A

Explanation

A. Hyponatremia and hyperkalemia: In the oliguric phase, the kidneys retain potassium due to decreased excretion, leading to hyperkalemia. Hyponatremia occurs due to fluid retention and dilutional effects.

B. Hyperkalemia and hypophosphatemia: Hyperkalemia is expected, but hypophosphatemia is not typical; phosphate tends to accumulate due to reduced renal clearance.

C. Hypokalemia and hyponatremia: Hypokalemia is not expected; the kidneys fail to excrete potassium, causing hyperkalemia.

D. Hypernatremia and hypokalemia: Neither hypernatremia nor hypokalemia is consistent with the oliguric phase.

A. Notify the provider B. Irrigate the catheter C. Check the catheter for kinks D. Adjust the rate of the bladder irrigant

Correct Answer is C

Explanation

A. Notify the provider: This is not the first action. The nurse should assess and attempt to resolve the issue before escalating it to the provider.

B. Irrigate the catheter: This may be required if the catheter remains obstructed, but the nurse should first assess for and address more straightforward causes like kinks.

C. Check the catheter for kinks: This is the first step because a kink or simple obstruction in the catheter tubing is a common cause of inadequate drainage. Addressing this can resolve the issue without additional interventions.

D. Adjust the rate of the bladder irrigant: The rate of irrigation is essential to prevent clots but should not be adjusted without addressing the immediate issue of no output.

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A client with chronic renal failure has an internal arteriovenous fistula in the left arm for vascular access during hemodialysis. Which of the following is most important to include in the patient teaching? Select all that apply)

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Naxlex Comprehensive Predictor Exams

The nurse is caring for a client who is in the Oliguric phase of an Acute kidney injury. Which of the following electrolyte imbalances would be consistent with the condition?

Correct Answer is A

Explanation

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Correct Answer is C

Explanation

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