A nurse is caring for a client with end-stage renal disease (ESRD). The client's blood work shows elevated levels of creatinine, blood urea nitrogen (BUN), and potassium. Which of the following conditions is the primary indication for initiating dialysis?

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.

A. Correct. Applying pressure to the bleeding site is the first action to control the bleeding and prevent excessive blood loss.

B. Incorrect. Elevating the arm above heart level may not be effective in controlling bleeding from the access site and could cause unnecessary discomfort.

C. Incorrect. Administering a prescribed antiplatelet medication is not the first action to take when the client experiences bleeding from the access site, as it may further increase bleeding risk.

D. Incorrect. While checking the client's platelet count is important, it is not the first action to address active bleeding. Applying pressure to the bleeding site takes priority to control the bleeding.

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