A nurse is caring for a client with chronic renal failure who is receiving peritoneal dialysis. The client reports cloudy dialysate effluent during an exchange. What should the nurse do first?

Assess the client's vital signs and blood pressure.

Obtain a sample of the cloudy effluent for testing.

Instruct the client to stop the exchange immediately.

Provide the client with an analgesic for pain relief.

Answer and Explanation

The Correct Answer is B

A. Incorrect. While assessing vital signs and blood pressure is important, it is not the first action when the client reports cloudy dialysate effluent during an exchange.

B. Correct. Cloudy dialysate effluent may indicate peritonitis, an infection of the peritoneal cavity. Obtaining a sample of the effluent for testing is the first action to determine if an infection is present and requires immediate treatment.

C. Incorrect. Instructing the client to stop the exchange immediately may be necessary if there are signs of infection or other complications, but obtaining a sample of the effluent should be done first to determine the cause.

D. Incorrect. Providing the client with an analgesic is not the priority when the client reports cloudy dialysate effluent; the focus is on identifying the cause of the cloudiness.

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Correct Answer is C

Explanation

A. Incorrect. Antibiotics are generally safe and are not known to be a risk factor for chronic renal failure.

B. Incorrect. Antihypertensive medications are essential for managing high blood pressure and reducing the risk of kidney damage in individuals with hypertension. They are not considered a risk factor for chronic renal failure.

C. Correct. Proton pump inhibitors (PPIs) are commonly used to treat conditions such as acid reflux and peptic ulcers. Prolonged and high-dose use of PPIs has been associated with an increased risk of kidney disease, including acute interstitial nephritis and chronic kidney disease.

D. Incorrect. Antipyretics such as acetaminophen are generally safe when used appropriately and are not considered a risk factor for chronic renal failure.

A. Provide the client with a heating pad to apply to the affected muscles. B. Encourage the client to increase fluid intake. C. Administer a prescribed calcium supplement. D. Educate the client about the importance of potassium-rich foods.

Correct Answer is B

Explanation

A. Incorrect. Applying a heating pad may provide temporary relief for muscle cramps, but it does not address the underlying cause.

B. Correct. Muscle cramps in clients with chronic renal failure can be caused by dehydration and electrolyte imbalances. Encouraging the client to increase fluid intake can help alleviate muscle cramps and maintain adequate hydration.

C. Incorrect. While calcium supplements may be prescribed in certain situations, they are not the first-line intervention for muscle cramps in chronic renal failure.

D. Incorrect. Educating the client about potassium-rich foods is important for managing potassium levels, but it is not the priority in this situation. Muscle cramps are more likely related to fluid and electrolyte imbalances rather than potassium intake.

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A nurse is caring for a client with chronic renal failure who is receiving peritoneal dialysis. The client reports cloudy dialysate effluent during an exchange. What should the nurse do first?

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Naxlex Comprehensive Predictor Exams

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