A nurse is assessing a client's arteriovenous fistula prior to hemodialysis, but does not hear a bruit or feel a thrill. Pulses distal to the fistula are not palpable, and the capillary refill is slow. Which of the following actions is the nurse's priority?

Proceed with hemodialysis.

Notify the provider immediately.

Raise the arm above the level of the patient's heart.

Apply warm packs to the fistula site and reassess.

Answer and Explanation

The Correct Answer is B

A.   This is incorrect and potentially dangerous. A non-functioning fistula will not provide adequate blood flow for dialysis and can lead to complications.
B.   This is the correct action. The nurse should immediately inform the healthcare provider about the compromised fistula. The provider can order further diagnostic tests or interventions as needed.

C.   This might improve blood flow temporarily, but it is not a definitive solution and does not address the underlying issue.
D.   While warm packs can sometimes improve circulation, it is unlikely to resolve the serious issues found in this case.

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Correct Answer is A

Explanation

A. This is an inflammation of the peritoneum, the lining of the abdominal cavity. It's a common complication of peritoneal dialysis (PD). Symptoms include nausea, vomiting, diarrhea, abdominal pain, and fever. Fluid discharge from the catheter site and an increased white blood cell count are also indicative of infection, supporting the diagnosis of peritonitis.
B. This is inflammation of the pericardium, the sac surrounding the heart. Symptoms typically include chest pain, shortness of breath, and irregular heartbeat.
C. This is inflammation of the pleura, the membranes surrounding the lungs. Symptoms include chest pain, shortness of breath, and dry cough.
D. This would present with severe abdominal pain, hypotension, and signs of shock. Nausea, vomiting, and diarrhea are not typical symptoms.

A. "If you experience chronic rejection, you will not be eligible to go back onto the transplant list." B. "You are at an increased risk of developing benign prostatic hyperplasia after a transplant." C. "You should limit your fluid intake to 1,500 mL per day so your new kidney will not have to work as hard." D. "Immunosuppressants can make hypertension worse, so you may need to go on blood pressure medication."

Correct Answer is D

Explanation

A. This is incorrect. While chronic rejection is a serious complication, patients who experience it can often receive another transplant.
B. This is incorrect and unrelated to kidney transplant.
C. This is incorrect. Adequate hydration is essential for proper kidney function.
D. This is correct. Immunosuppressants can contribute to hypertension, a common complication after kidney transplant.

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A nurse is assessing a client's arteriovenous fistula prior to hemodialysis, but does not hear a bruit or feel a thrill. Pulses distal to the fistula are not palpable, and the capillary refill is slow. Which of the following actions is the nurse's priority?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A patient who performs dialysis at home using a catheter placed through the abdominal wall reports nausea, vomiting, diarrhea, and fluid discharge from the catheter site. The laboratory reports reveal an increased white blood cell count (WBC). Which condition does the nurse suspect in the patient?

Correct Answer is A

Explanation

A client who received a kidney transplant last month is in the nephrology clinic for a follow-up visit. Which education should the nurse provide to the client regarding complications which can arise after a kidney transplant?

Correct Answer is D

Explanation

A nurse is assessing a client who has chronic kidney disease (CKD) for fluid volume overload prior to scheduled hemodialysis. Which of the following methods provides a reliable measurement of the amount of fluid the client has retained since the last dialysis treatment?

A nurse is reviewing laboratory findings for four clients. Which of the following clients has manifestations of untreated chronic kidney disease?

A nurse is admitting a client who has been diagnosed with acute glomerulonephritis. Considering the most common cause of this condition, which test should the nurse anticipate will be performed?

Which of the following clients is at risk of developing acute kidney injury from a post-renal cause?

A client with acute kidney injury (AKI) has a serum potassium level of 6.5 mEq/L. The nurse recognizes that administering IV calcium gluconate to this client will result in which of the following effects?

A client with chronic kidney disease (CKD) has a serum potassium level of 6.5 mEq/L. Which of the following medications removes excess potassium from the body?