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?
Hypertension
Hypercalcemia
Hyperkalemia
Hypokalemia
The Correct Answer is C
A) This statement is incorrect. Hypertension (high blood pressure) is a common complication of kidney disease, but it is not the primary indication for initiating dialysis. Dialysis is primarily indicated to address the impaired filtration and waste removal functions of the kidneys, which can lead to electrolyte imbalances like hyperkalemia.
B) This statement is incorrect. Hypercalcemia (elevated calcium levels) is not a primary indication for initiating dialysis. While calcium imbalances can be associated with kidney disease, hyperkalemia takes precedence as a more critical indication for dialysis initiation.
C) This statement is accurate. Hyperkalemia (elevated potassium levels) is a critical indication for initiating dialysis. Dialysis helps remove excess potassium from the bloodstream when the kidneys are unable to do so, preventing potentially life-threatening complications.
D) This statement is incorrect. Hypokalemia (low potassium levels) is not an indication for initiating dialysis. In fact, dialysis may lead to a reduction in potassium levels, and clients on dialysis are more likely to experience hyperkalemia.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
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.
Correct Answer is C
Explanation
A) This statement is incorrect. Increasing the rate of fluid removal during dialysis may worsen the client's symptoms of lightheadedness and dizziness, as it can lead to further drops in blood pressure.
B) This statement is incorrect. Administering an antihypertensive medication is not appropriate in this situation, as the client is experiencing symptoms of low blood pressure, not high blood pressure.
C) This statement is accurate. Feeling lightheaded and dizzy during hemodialysis may be a sign of hypotension (low blood pressure), and the nurse should assess the client's blood pressure and pulse rate to determine if intervention is needed.
D) This statement is incorrect. Elevating the client's legs may promote blood flow, but it does not address the immediate issue of lightheadedness and dizziness. Assessing the client's blood pressure and pulse rate is the priority to determine the appropriate intervention.
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