Because of difficulties with hemodialysis, peritoneal dialysis is initiated to treat a client's uremia. Which finding during this procedure signals a significant problem?
White blood cell (WBC) count of 20,000/mm3
Blood glucose level of 200 mg/dl
Potassium level of 3.5 mEq/L
Hematocrit (HCT) of 35%
The Correct Answer is A
A. WBC count of 20,000/mm³ indicates a possible infection, such as peritonitis — a serious and common complication of peritoneal dialysis that requires immediate intervention.
B. Blood glucose of 200 mg/dL can occur with glucose-based dialysate, especially in diabetic clients, and is managed medically.
C. Potassium of 3.5 mEq/L is at the low-normal range and not an immediate concern.
D. Hematocrit of 35% is within a relatively acceptable range and not typically urgent.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. BUN of 45 mg/dL and creatinine of 8 mg/dL are elevated and consistent with chronic kidney disease due to the kidneys’ reduced ability to excrete waste products.
B. Creatinine of 0.3 mg/dL is below the normal range, not consistent with CKD.
C. These values are within the normal range and would not indicate CKD.
D. These are both normal values, not expected in a client with chronic kidney disease.
Correct Answer is B
Explanation
A. Preprocedure hydration with 0.45% NaCl may be considered, but isotonic fluids like 0.9% NaCl are generally preferred to help flush the contrast agent.
B. Administration of acetylcysteine is commonly ordered to help reduce the risk of contrast-induced nephropathy in clients with elevated creatinine levels.
C. Hemodialysis prior to the CT scan is not routinely performed unless the client is already dialysis-dependent.
D. Creatinine clearance via 24-hour urine is not an urgent pre-procedure requirement; the elevated serum creatinine already indicates impaired renal function.
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