A nurse is assessing a client diagnosed with end-stage renal disease (ESRD) that is receiving hemodialysis. Which of the following findings should the nurse identify as an indication that the client is experiencing fluid overload?

Oxygen saturation 93%

Distended neck veins

The client has gained 1 pound since yesterday.

Return of skin to previous position when the client's shin is palpated

Answer and Explanation

The Correct Answer is B

A. Oxygen saturation 93%:
While this is slightly below normal, it is not a definitive or specific indicator of fluid overload.

B. Distended neck veins:
Jugular vein distention is a classic sign of fluid overload and increased central venous pressure.

C. The client has gained 1 pound since yesterday:
A 1-pound weight gain could be due to fluid retention, but it's not significant enough on its own to confirm fluid overload.

D. Return of skin to previous position when the client's shin is palpated:
This indicates normal skin turgor and does not suggest fluid overload; instead, it rules out dehydration.

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Correct Answer is B

Explanation

A. Bradycardia: Peritonitis is usually associated with tachycardia, not bradycardia.

B. Nausea and vomiting: These are common early signs of peritonitis, often accompanied by abdominal pain and fever.

C. Increased urinary output: Clients with peritoneal dialysis often have reduced kidney function, so urine output is generally decreased, not increased.

D. Hyperactive bowel sounds: Bowel sounds are usually diminished or hypoactive in peritonitis due to inflammation.

A. Decreased serum sodium B. Decreased serum phosphorus C. Decreased urine specific gravity D. Decreased serum potassium

Correct Answer is D

Explanation

A. Decreased serum sodium: Kayexalate exchanges sodium for potassium, so sodium may actually increase.

B. Decreased serum phosphorus: Kayexalate does not directly affect phosphate levels.

C. Decreased urine specific gravity: Kayexalate does not influence urine output or concentration.

D. Decreased serum potassium: Kayexalate treats hyperkalemia by exchanging potassium ions for sodium in the intestines, lowering serum potassium.

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A nurse is assessing a client diagnosed with end-stage renal disease (ESRD) that is receiving hemodialysis. Which of the following findings should the nurse identify as an indication that the client is experiencing fluid overload?

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Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who is receiving peritoneal dialysis. The nurse should monitor the client for which of the following manifestations of peritonitis?

Correct Answer is B

Explanation

A nurse is caring for a client receiving sodium polystyrene sulfonate (Kayexalate) for the treatment of chronic renal disease. The nurse should monitor for which therapeutic effect of sodium polystyrene sulfonate (Kayexalate)?

Correct Answer is D

Explanation

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