A nurse is teaching a client undergoing hemodialysis about the importance of maintaining vascular access. Which statement by the client indicates a correct understanding of the teaching?

"I should avoid using the arm with the arteriovenous (AV) fistula for blood pressure measurements."

"I can use the AV fistula arm for intravenous catheter insertion."

"I should avoid performing self-cannulation of my AV graft."

"I can apply pressure to my AV fistula site if it starts bleeding."

Answer and Explanation

The Correct Answer is A

A. Correct. Using the arm with the AV fistula for blood pressure measurements can compress the vascular access and compromise blood flow. It is important to avoid using the fistula arm for blood pressure measurements and venipuncture.

B. Incorrect. The AV fistula should not be used for intravenous catheter insertion to prevent potential damage and infection to the access site.

C. Incorrect. Self-cannulation of the AV graft is typically performed by healthcare professionals, and clients should not attempt to self-cannulate their vascular access.

D. Incorrect. If an AV fistula starts bleeding, the client should not apply pressure to the site. Instead, they should immediately elevate the arm and apply pressure to the bleeding site with a clean cloth or bandage while seeking medical attention.

QUESTIONS

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Correct Answer is B

Explanation

A. Incorrect. While administering an antiepileptic medication may be necessary if the client is experiencing seizures, it is essential to identify the underlying cause first.

B. Correct. The client's severe headache, confusion, and seizures may be indicative of dialysis disequilibrium syndrome, which is a complication of rapid solute removal during hemodialysis. Hypoglycemia can also present with similar symptoms, so assessing blood glucose levels is crucial to differentiate between the two conditions.

C. Incorrect. Documenting the findings and monitoring the client's condition are important, but addressing the acute symptoms and potential cause should be the priority.

D. Incorrect. Checking the client's pre-dialysis weight is not the priority when the client is experiencing severe neurological symptoms. Immediate assessment and intervention are needed.

A. Collect a sample of the effluent for culture and sensitivity testing. B. Instruct the client to stop the exchange immediately. C. Notify the healthcare provider about the cloudy effluent. D. Encourage the client to perform another exchange.

Correct Answer is C

Explanation

A. Incorrect. Collecting a sample of the effluent for culture and sensitivity testing may be necessary, but notifying the healthcare provider about the finding should be done first.

B. Incorrect. Stopping the exchange immediately may be necessary in some cases, but the nurse should first communicate the finding to the healthcare provider for further assessment and guidance.

C. Correct. Cloudy dialysate effluent may indicate peritonitis, an infection of the peritoneal cavity, which requires immediate attention and treatment by the healthcare provider.

D. Incorrect. Encouraging the client to perform another exchange without further assessment can potentially exacerbate any underlying issue causing the cloudy effluent.

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A nurse is teaching a client undergoing hemodialysis about the importance of maintaining vascular access. Which statement by the client indicates a correct understanding of the teaching?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client on hemodialysis presents with a severe headache, confusion, and seizures. What action should the nurse take first?

Correct Answer is B

Explanation

A client receiving peritoneal dialysis reports cloudy dialysate effluent during an exchange. What should the nurse do first?

Correct Answer is C

Explanation

A nurse is providing education to a client with chronic kidney disease (CKD). The client asks about the purpose of dialysis. Which of the following responses by the nurse is accurate?

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A client on peritoneal dialysis reports experiencing abdominal pain and fever. What should the nurse do first?

A nurse is caring for a client on hemodialysis who complains of headache and restlessness. The client's blood pressure is elevated compared to baseline. Which of the following actions should the nurse take first?

A nurse is caring for a client with end-stage renal disease (ESRD) who is starting peritoneal dialysis. The client expresses concerns about the impact on their daily activities. Which of the following responses by the nurse is appropriate?

A nurse is caring for a client with end-stage renal disease (ESRD). The client presents with severe fluid overload, pulmonary edema, and uncontrolled hypertension. Which of the following is the primary indication for initiating dialysis in this client?

A client on hemodialysis has a history of arteriovenous (AV) fistula creation. Which of the following assessments should the nurse perform to ensure proper functioning of the AV fistula?

A nurse is caring for a client with chronic kidney disease (CKD) who is scheduled to start hemodialysis. The client asks, "How does hemodialysis work?" Which of the following responses by the nurse is accurate?