A client with end-stage renal disease (ESRD) has been on hemodialysis for 3 years. The client chooses to discontinue dialysis, and to begin receiving hospice services at home with day-to-day care provided by family members. The hospice nurse performs an assessment on the client 7 days after the client last received a dialysis treatment. Which assessment finding would not be expected for this client?
Pruritis
Lethargy
Polyuria
Uremic frost
The Correct Answer is C
A. This is a common symptom of uremia, which is the buildup of waste products in the blood due to kidney failure. It is expected in a patient with ESRD who has discontinued dialysis.
B. As the body accumulates waste products, fatigue and lethargy are common symptoms of uremia. This is expected in a patient with ESRD who has discontinued dialysis.
C. Polyuria is excessive urination. With kidney failure, the kidneys are unable to concentrate urine, leading to oliguria or anuria, not polyuria. Therefore, polyuria would not be expected in this patient.
D. This is a white, crystalline deposit on the skin caused by the accumulation of urea and uric acid. It is a sign of severe uremia and would be expected in a patient with ESRD who has discontinued dialysis.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. Hyperkalemia and hypernatremia are generally not associated with the diuretic phase of AKI. In the diuretic phase, the primary issue is excessive loss of electrolytes and fluid, rather than their accumulation.
B. Hypokalemia can occur during the diuretic phase because diuretics increase the excretion of potassium along with water. Hypernatremia is not typical of the diuretic phase. Instead, sodium levels might decrease or remain normal due to the loss of fluid and electrolytes.
C. Hyperkalemia is unlikely during the diuretic phase as diuretics often lead to increased potassium loss. Hyponatremia is a more likely outcome during the diuretic phase due to the loss of sodium and fluid through increased urine output.
D. During the diuretic phase of AKI, there is significant loss of electrolytes, including potassium and sodium. Diuretics increase urine output, leading to the loss of potassium and sodium, which can occur as a result of excessive fluid and electrolyte loss.
Correct Answer is B
Explanation
A. This is a pre-renal cause of acute kidney injury, related to decreased blood flow to the kidneys.
B. This is a post-renal cause of acute kidney injury, as it obstructs the outflow of urine.
C. This is an intrarenal cause of acute kidney injury, directly affecting the kidney tissue.
D. This is an intrarenal cause of acute kidney injury, related to damage to the small blood vessels in the kidneys.
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