A nurse is reinforcing teaching for a client who has chronic kidney disease about the process of continuous ambulatory peritoneal dialysis (CAPD). Which of the following should the nurse include in the teaching?
CAPD dialysis is the treatment of choice for a client who has a history of abdominal trauma
The dialyzing solution infuses using an infusion pump
The dialysis is continuous 24 hours a day, 7 days a week
The dialyzing solution is suspended at the level of the umbilicus during the infusion
The Correct Answer is C
Choice a reason: CAPD is not typically the treatment of choice for a client who has a history of abdominal trauma. Abdominal trauma can cause complications and may affect the peritoneal cavity's ability to act as a dialyzing membrane, making peritoneal dialysis less suitable. Clients with a history of abdominal issues may be better suited for other forms of dialysis, such as hemodialysis.
Choice b reason: The dialyzing solution in CAPD does not infuse using an infusion pump. Instead, it is infused into the peritoneal cavity by gravity through a catheter. The client manually controls the infusion process by hanging the dialysate bag at an appropriate height to allow gravity to facilitate the flow of the solution into the peritoneal cavity.
Choice c reason: The dialysis is continuous 24 hours a day, 7 days a week. CAPD involves multiple exchanges of dialysate throughout the day, with each dwell time typically lasting 4-6 hours. The process is continuous, providing ongoing filtration and waste removal, which helps manage the symptoms and complications of chronic kidney disease.
Choice d reason: The dialyzing solution is not suspended at the level of the umbilicus during the infusion. Instead, the dialysate bag is typically hung higher than the client's abdomen to use gravity for infusion. The height of the bag helps control the flow rate of the solution into the peritoneal cavity. Proper technique is essential to ensure effective dialysis and prevent complications.
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Related Questions
Correct Answer is C
Explanation
Choice a reason: Starting the flow of urine before passing the container under the stream to collect the specimen is an appropriate instruction. This technique is recommended to ensure that the initial part of the urine, which may contain contaminants from the urethral opening, is not collected. By allowing the first part of the urine to flow into the toilet, the midstream portion is considered cleaner and more representative for diagnostic testing.
Choice b reason: Removing the specimen container before stopping the stream of urine is also an appropriate instruction. This helps to ensure that only the midstream portion of the urine is collected, minimizing the risk of contamination from the skin or other surfaces. It also prevents the urine from splashing or overflowing, which could potentially contaminate the sample or the surrounding area.
Choice c reason: Using the provided towelette to cleanse the area by moving in a back-and-forth motion is incorrect and requires intervention. The proper technique for cleansing the area involves using the towelette to wipe from front to back in a single, continuous motion. This helps to reduce the risk of introducing bacteria from the perineal area into the urinary tract, which can lead to inaccurate test results or urinary tract infections.
Choice d reason: Instructing the client to use their non-dominant hand to spread the labia is an appropriate instruction. This technique helps to ensure that the urinary meatus is exposed and that the urine flows directly into the specimen container. Using the non-dominant hand allows the dominant hand to be used for holding and positioning the specimen container, making the process more manageable and reducing the risk of contamination.
Correct Answer is A
Explanation
Choice a reason: Straining all urine is an essential intervention for a patient with a kidney stone. This practice allows for the collection and analysis of any stones that pass, which can help determine their composition and guide future treatment and dietary recommendations. Identifying the type of stone is crucial for preventing recurrence.
Choice b reason: Restricting fluids is not recommended for patients with kidney stones. In fact, increasing fluid intake is encouraged to help flush out the urinary system, promote the passage of stones, and prevent the formation of new stones. Adequate hydration is a key component in managing and preventing kidney stones.
Choice c reason: Increasing calcium intake is not typically advised for patients with kidney stones, especially calcium oxalate stones. While calcium is an essential nutrient, excessive intake can contribute to stone formation. Dietary recommendations should be individualized based on the type of stones and the patient's overall health.
Choice d reason: Maintaining bedrest is not necessary for patients with kidney stones. Encouraging movement and activity can help facilitate the passage of stones. Bedrest may be recommended in specific cases where the patient is experiencing severe pain or complications, but generally, mobility is beneficial in managing kidney stones.
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