A male client with acute kidney injury (AKI) is scheduled for his first hemodialysis treatment and asks the practical nurse (PN) how the treatments will be evaluated for effectiveness. The PN explains that blood samples will be collected for analysis. Which laboratory value should the PN explain as the best indicator of each hemodialysis?
Elevated potassium.
Decreased calcium.
Lowered hemoglobin.
Decreased creatinine.
The Correct Answer is D
Hemodialysis is a procedure used to remove waste products and excess fluid from the blood when the kidneys are unable to function properly. One of the waste products that accumulate in the blood during kidney dysfunction is creatinine. Creatinine is a byproduct of muscle metabolism, and its levels in the blood are normally regulated and eliminated by the kidneys. In AKI, the kidneys are not able to effectively filter and eliminate creatinine, leading to elevated levels in the blood. Hemodialysis helps to remove excess creatinine from the blood, resulting in decreased creatinine levels.
A- Elevated potassium levels (hyperkalemia) are common in AKI and can be life-threatening. Hemodialysis helps to remove excess potassium from the blood, restoring normal levels.
However, the best indicator of the effectiveness of hemodialysis in managing hyperkalemia would be monitoring the potassium levels before and after the session rather than considering it as the "best" indicator.
B- Decreased calcium levels can occur in kidney dysfunction due to impaired activation of vitamin D and decreased absorption of calcium from the intestines. While hemodialysis can help restore calcium levels, it may not be the primary laboratory value used to evaluate the effectiveness of each session.
C- Lowered hemoglobin levels can be seen in AKI due to various factors, including decreased production of red blood cells and blood loss. Hemodialysis can help remove waste products and excess fluid, but it may not directly address the underlying causes of lowered hemoglobin levels.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A: Document the client's loss of memory in the record.
While it's important to document changes in a patient's condition, this should not be the first action. The confusion might be temporary and due to the new environment. It's crucial to first address the patient's immediate needs.
Choice B: Remind the client what day of the week it is.
This is the best action to take. The patient is likely experiencing "relocation stress syndrome," which can cause confusion and disorientation in a new environment. Reminding her of the day can help reorient her and alleviate her confusion.
Choice C: Encourage the client to rest during the day.
While rest is important, it doesn't directly address the patient's confusion about the day of the week. Furthermore, excessive daytime sleep can disrupt the patient's sleep-wake cycle and potentially exacerbate confusion.
Choice D: Notify the family of the change in the client's condition.
While it's important to keep the family informed, this should not be the first action. The nurse should first address the patient's confusion and monitor her to see if the confusion persists or improves.
Correct Answer is B
Explanation
Bathing a bedfast client with the bed in a high position poses a potential risk to the client's safety. Lowering the bed to a safe height is important to prevent falls and injuries during the bathing procedure. The PN should promptly intervene and instruct the UAP to lower the bed to an appropriate level before continuing with the bathing process.
A. While remaining in the room to supervise the UAP is important, it should be done after ensuring the client's safety by lowering the bed. If the bed is not lowered, the risk of injury remains, and the PN should take immediate action to address the safety concern.
C. Determining if the UAP would like assistance is a valid consideration, but it should be secondary to addressing the safety issue of the bed height. Once the bed is lowered, the PN can assess if additional assistance is required and provide support accordingly.
D. Assuming care of the client immediately may be necessary if the client is in immediate danger or experiencing an urgent medical situation. However, in this case, the primary concern is addressing the safety issue related to the bed height, and the PN can address this by instructing the UAP to lower the bed.
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