A nurse is caring for a client with chronic kidney disease (CKD) who is scheduled to start hemodialysis. The client asks, "How does hemodialysis work?" Which of the following responses by the nurse is accurate?
"Hemodialysis involves the removal of the peritoneal membrane to filter blood."
"Hemodialysis uses a machine to filter blood outside of your body and then return it."
"Hemodialysis relies on the use of a catheter inserted into your bladder to remove waste."
"Hemodialysis uses a pump to circulate dialysate through your intestines."
The Correct Answer is B
A) This statement is incorrect. Hemodialysis does not involve the removal of the peritoneal membrane; that description is characteristic of peritoneal dialysis.
B) This statement is accurate. Hemodialysis uses a machine called a dialyzer to filter blood outside the body, removing waste products and excess fluid before returning the clean blood to the patient.
C) This statement is incorrect. Hemodialysis does not rely on a catheter inserted into the bladder; that description is characteristic of urinary catheterization.
D) This statement is incorrect. Hemodialysis does not use a pump to circulate dialysate through the intestines; that description is characteristic of peritoneal dialysis.
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Correct Answer is D
Explanation
A) This statement is incorrect. While administering an antibiotic may be necessary if peritonitis is confirmed, it should not be done without obtaining a sample for testing first.
B) This statement is incorrect. Measuring vital signs and assessing for pain are essential aspects of client assessment, but they may not provide enough information to determine the cause of the cloudy drainage.
C) This statement is incorrect. Clamping the catheter may be necessary if peritonitis is suspected, but it should not be done without first obtaining a sample of the drainage for testing.
D) This statement is accurate. Cloudy drainage from the catheter site may indicate peritonitis, which is an infection of the peritoneal cavity. Obtaining a sample of the drainage for culture and sensitivity testing can help identify the presence of infection and guide appropriate treatment.
Correct Answer is D
Explanation
A) This statement is incorrect. Hypoglycemia (low blood glucose) is not the primary indication for initiating dialysis. Hypoglycemia can occur in certain situations, but it is not the primary concern in this case.
B) This statement is incorrect. Hyperkalemia (elevated potassium levels) can be a concern in AKI, but it is not the primary indication described in the scenario. The primary concern in AKI with decreased GFR is the impaired filtration and waste removal, leading to the need for dialysis.
C) This statement is incorrect. Hypernatremia (high sodium levels) is not a primary indication for initiating dialysis in AKI. Hypernatremia is rare in AKI and usually occurs when there is a significant loss of free water compared to sodium intake.
D) A significantly decreased glomerular filtration rate (GFR) indicates that the kidneys' ability to filter waste products and excess fluids from the blood is severely impaired. Dialysis can help support kidney function and remove waste products when the GFR is critically low.
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