A nurse is preparing a teaching plan for a client who is starting to receive hemodialysis for chronic kidney disease. Which of the following instructions should the nurse include in the teaching?

"Use salt substitutes to reduce your sodium intake."

"Increase your fluid intake to 1,000 mL a day."

"Include phosphorus-rich foods in your diet."

"Avoid food products that contain trans-fats."

Answer and Explanation

The Correct Answer is D

Rationale:
A. "Use salt substitutes to reduce your sodium intake.": Salt substitutes often contain potassium, which can accumulate to dangerous levels in clients with chronic kidney disease. Therefore, they should be avoided rather than recommended.

B. "Increase your fluid intake to 1,000 mL a day.": Clients on hemodialysis typically require fluid restrictions, not increases, to prevent fluid overload between dialysis sessions. Fluid allowances are individualized based on urine output and clinical status.

C. "Include phosphorus-rich foods in your diet.": Phosphorus levels tend to rise in clients with kidney failure, contributing to bone disease. These clients are advised to avoid phosphorus-rich foods like dairy, nuts, and cola beverages.

D. "Avoid food products that contain trans-fats.": Clients with chronic kidney disease are at increased risk for cardiovascular disease. Avoiding trans-fats, which raise LDL cholesterol and promote inflammation, supports heart health and is an appropriate dietary recommendation.

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Correct Answer is D

Explanation

Rationale:
A. Decreased calcium levels: Hypocalcemia may cause neuromuscular symptoms such as tetany or tingling but is not associated with exophthalmos (protruding eyes). Calcium imbalance does not typically cause changes in eye appearance.

B. Decreased somatotropin levels: Somatotropin (growth hormone) deficiency may lead to growth delay or reduced muscle mass, but it is not associated with changes in orbital appearance. Protruding eyes are unrelated to growth hormone levels.

C. Increased glucose levels: Elevated glucose is characteristic of diabetes mellitus and may lead to complications like neuropathy or retinopathy, but it does not cause eye protrusion.

D. Increased T4 levels: Elevated thyroxine (T4) is seen in hyperthyroidism, particularly in Graves' disease, which is strongly associated with exophthalmos. The protrusion results from inflammation and edema of orbital tissues, a hallmark of this thyroid disorder.

A. WBC count B. Intake and output C. ABGs D. Blood glucose level

Correct Answer is C

Explanation

Rationale:

A. WBC count: Monitoring the white blood cell count is useful for detecting infection, but heroin toxicity primarily affects the respiratory system. An elevated or normal WBC does not provide immediate information about the client's ventilation or gas exchange status.

B. Intake and output: Tracking fluid balance is important for overall patient monitoring, especially in critically ill clients. However, it does not provide direct insight into the effectiveness of mechanical ventilation or the client's oxygenation status.

C. ABGs: Arterial blood gases are the priority assessment because they directly measure the client's oxygenation, ventilation (CO₂ removal), and acid-base status. Since heroin toxicity can cause respiratory depression, ABGs are essential to evaluate the effectiveness of mechanical ventilation.

D. Blood glucose level: Although monitoring glucose is important in critically ill clients, heroin use is not typically associated with hypo- or hyperglycemia. Blood glucose assessment is not as urgent as evaluating respiratory function in this scenario.

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A nurse is preparing a teaching plan for a client who is starting to receive hemodialysis for chronic kidney disease. Which of the following instructions should the nurse include in the teaching?

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Naxlex Comprehensive Predictor Exams

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