A nurse is assessing a client with chronic renal failure. Which clinical manifestation should the nurse recognize as a common early symptom of kidney dysfunction?

A. Incorrect. Proteinuria, or the presence of excessive protein in the urine, may be a symptom of kidney dysfunction, but it is not directly related to periorbital edema and swelling of the ankles and feet.

B. Incorrect. Hypokalemia, or low potassium levels, may cause muscle weakness and other symptoms but is not associated with the specific edema described.

C. Incorrect. Hypernatremia, or high sodium levels, may lead to symptoms such as thirst and confusion but does not typically cause peripheral edema.

D. Correct. Periorbital edema (swelling around the eyes) and edema in the ankles and feet are classic signs of fluid overload in chronic renal failure. The impaired kidney function in chronic renal failure leads to the retention of fluid and sodium in the body, resulting in edema.

A. Correct. Peripheral neuropathy, characterized by tingling sensations or "pins and needles" in the hands and feet, is a common neurological complication of chronic renal failure. Uremic toxins build up in the blood when the kidneys are unable to adequately filter waste products, leading to nerve damage and peripheral neuropathy.

B. Incorrect. Increased blood flow to the extremities is not typically associated with the "pins and needles" sensation described by the client.

C. Incorrect. Adequate nerve conduction related to calcium levels would not cause the "pins and needles" sensation; instead, disturbances in calcium levels can lead to other neurological symptoms.

D. Incorrect. Hypokalemia, or low potassium levels, can cause muscle weakness or cramps but is not typically associated with peripheral neuropathy.