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. Verify the alarm settings on the ventilator: Ensuring alarms are properly set is a routine safety check but does not directly address the client's agitation or risk of self-extubation. It is important but not the priority action in this scenario.

B. Turn on the television: Providing distraction may help reduce mild anxiety but is insufficient for managing significant agitation in a mechanically ventilated client who may become dangerous to themselves if they pull out the endotracheal tube.

C. Obtain a prescription for a vest restraint: Physical restraints should be a last resort after attempting less restrictive methods. Using restraints without addressing the underlying cause of agitation (e.g., discomfort, anxiety, pain) can increase distress and injury risk.

D. Administer a sedative medication: Sedation is appropriate for a mechanically ventilated client who is agitated and at risk for self-extubation. Sedatives help ensure patient comfort, reduce anxiety, and promote ventilator synchrony while protecting the airway.

A. BUN 16 mg/dL (10 to 20 mg/dL) B. Urine output 40 mL every hour for 3 hr C. Hct 42% (37% to 47%) D. Surgical drain output 300 mL during an 8-hr shift

Correct Answer is D

Explanation

Rationale:
A. BUN 16 mg/dL (10 to 20 mg/dL): This is a normal blood urea nitrogen level and does not indicate dehydration or fluid volume deficit. Elevated BUN may suggest volume depletion, but this value is within the expected range.

B. Urine output 40 mL every hour for 3 hr: A urine output of 30 mL/hr or greater is considered adequate in most adult clients. Therefore, 40 mL/hr is within acceptable limits and does not suggest fluid volume deficit.

C. Hct 42% (37% to 47%): This hematocrit level falls within the normal range and does not indicate hemoconcentration. Elevated hematocrit could signal dehydration, but this value alone does not support that conclusion.

D. Surgical drain output 300 mL during an 8-hr shift: This is a significant amount of fluid loss postoperatively and can contribute to fluid volume deficit. High drain output following surgery, especially spinal procedures, increases the client's risk for hypovolemia and should be closely monitored.

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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?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is D

Explanation

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Correct Answer is D

Explanation

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