A nurse is caring for a client on hemodialysis who complains of headache and restlessness. The client's blood pressure is elevated compared to baseline. Which of the following actions should the nurse take first?

A) This statement is incorrect. Cloudy dialysate drainage may indicate infection or peritonitis, and the nurse should not simply document the finding and continue monitoring without further assessment.

B) This statement is incorrect. Administering an antibiotic medication without a definitive diagnosis is not appropriate. The nurse should assess the client further to determine the cause of the cloudy drainage.

C) This statement is incorrect. Increasing the dialysis exchange frequency would not address the issue of cloudy dialysate drainage and may not be indicated without a proper assessment.

D) This statement is correct. Cloudy dialysate drainage may indicate infection or peritonitis. The nurse should check the client's vital signs and assess for signs of abdominal pain or tenderness, as this requires immediate evaluation.

A) This statement is incorrect. Hypernatremia (high sodium levels) is not the primary indication for initiating dialysis in this case. Metabolic acidosis and the inability of the kidneys to excrete acids are the primary concerns.

B) This statement is incorrect. Hyperkalemia (elevated potassium levels) may occur in CKD, but it is not the primary indication described in the scenario. Metabolic acidosis is the primary concern leading to the need for dialysis.

C) This statement is incorrect. Hypocalcemia (low calcium levels) can be a complication of CKD, but it is not the primary indication for initiating dialysis in this scenario. Metabolic acidosis and its associated symptoms take precedence.

D) Severe metabolic acidosis, which results from the kidneys' inability to adequately excrete acids and regulate pH balance, is a critical indication for initiating dialysis in clients with CKD.