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 C

Explanation

A. Temperature 36.1° C (97.0°F): A low or normal temperature is not indicative of organ rejection. Fever (≥ 38°C / 100.4°F) is a more concerning sign and may suggest rejection or infection.

B. Weight loss: Rejection often leads to fluid retention, not weight loss. Clients may actually experience weight gain due to fluid overload.

C. Hypertension: Hypertension is a key indicator of acute kidney rejection due to inflammation and impaired kidney function, leading to fluid retention and increased blood pressure. Rejection can cause renal vascular resistance and reduced urine output, leading to fluid overload and elevated blood pressure.

D. Insomnia: Insomnia is not a direct symptom of rejection. It may be due to medications like corticosteroids (e.g., prednisone), anxiety, or post-transplant stress.

A. Draw daily labs B. Transport the urine specimen to the lab C. Provide perineal care with soap and water around a urinary catheter D. Insert the foley catheter E. Assist the incontinent patient to the commode at regular intervals

Correct Answer is ["B","C","E"]

Explanation

A. Drawing daily labs: This is a clinical task that requires specialized knowledge and skills and should not be delegated to UAP.

B. Transport the urine specimen to the lab: This is a non-clinical task that UAP can perform.

C. Provide perineal care with soap and water around a urinary catheter: UAP can assist with perineal care as it is a routine task that does not require clinical judgment.

D. Insert the foley catheter: Inserting a Foley catheter is a sterile procedure requiring clinical expertise and cannot be delegated to UAP.

E. Assist the incontinent patient to the commode at regular intervals: UAP can assist with toileting and incontinence care.

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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

A nurse is evaluating a client who underwent a kidney transplant 2 weeks ago. Which of the following clinical manifestations should the nurse recognize as potential indication of organ rejection?

Correct Answer is C

Explanation

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Explanation

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