A nurse is monitoring a client undergoing dialysis on the nephrology unit.
Which nursing actions are appropriate when providing emotional support to a patient undergoing peritoneal dialysis?
Provide antibiotic ointment to dialysis exit site
Encourage questions and discussions about fears
Monitor for signs of peritonitis
Restrict fluid intake without considering urinary output
The Correct Answer is {"A":{"answers":"B"},"B":{"answers":"A"},"C":{"answers":"A"},"D":{"answers":"B"}}
• Providing antibiotic ointment to the dialysis exit site is a medical order–driven intervention used for infection prevention, not a component of emotional support. While important in care, it does not directly address the psychosocial or supportive needs of the client during dialysis.
• Encouraging questions and discussions about fears allows the nurse to validate the client’s feelings, provide accurate education, and reduce anxiety. Open communication supports coping, enhances trust, and directly fulfills the provider’s order for emotional support and counseling.
• Monitoring for signs of peritonitis is primarily a clinical safety measure rather than emotional support, but it remains an anticipated nursing action during peritoneal dialysis. By ensuring early detection of infection, the nurse indirectly provides reassurance, which helps reduce patient anxiety about complications.
• Restricting fluid intake without considering urinary output is inappropriate because fluid management must be individualized. Overly strict restriction without assessing renal function and residual urine output may worsen the client’s sense of isolation and discomfort.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Apply absorbent adult incontinence diapers and pads over the bed linens: Absorbent products may help keep the skin dry, but it does not address the patient’s continence needs or promote independence. Prolonged use also increases risk of skin breakdown and infection.
B. Assist the patient to the bathroom every 2 hours during the day: Scheduled toileting supports continence, reduces the risk of falls, and promotes dignity. It also helps prevent skin complications from incontinence and reduces the likelihood of urinary tract infections.
C. Restrict fluids between meals and after the evening meal: Fluid restriction is not appropriate in dehydration, as the patient needs fluid replacement to restore balance. Limiting fluids could worsen confusion, impair perfusion, and further elevate the risk of complications
D. Insert an indwelling catheter until the symptoms have resolved: Indwelling catheters increase the risk of urinary tract infections, especially in older adults. Catheterization should be avoided unless absolutely necessary for close monitoring of urine output or in cases of urinary obstruction.
Correct Answer is D
Explanation
A. Patient who requires teaching about possible post-cystoscopy complications: Teaching requires assessment and specialized knowledge, which are within the registered nurse’s scope of practice. The LPN/VN can reinforce teaching but cannot take primary responsibility for initial patient education.
B. Patient who is scheduled for a renal biopsy after a recent kidney transplant: This patient is at high risk for complications such as bleeding and graft rejection, requiring close monitoring and advanced clinical judgment. Care for this patient should remain with the registered nurse.
C. Patient who will need monitoring for several hours after a renal arterogram: Post-arterogram monitoring involves assessing for bleeding, circulation changes, and possible contrast-related complications. These tasks require frequent assessment and higher-level clinical decision-making by the RN.
D. Patient who will have catheterization to check for residual urine after voiding: This is a stable patient requiring a routine procedure within the scope of practice for an experienced LPN/VN. Catheterization is a skill LPNs are trained to perform safely under the RN’s supervision, making this the appropriate delegation choice.
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