Select the signs and symptoms of anemia. Select All That Apply.

Rationale:

A. In end-stage renal disease (ESRD), the kidneys lose the ability to excrete phosphate efficiently, leading to hyperphosphatemia, not low phosphate levels. Elevated phosphate can contribute to secondary hyperparathyroidism and bone mineral disorders.

B. ESRD impairs potassium excretion, making hyperkalemia more common. Low potassium levels are not typical unless there are other contributing factors such as excessive diuretic use or gastrointestinal losses. Hyperkalemia in ESRD can be life-threatening due to its potential to cause cardiac arrhythmias.

C. In ESRD, the kidneys are unable to excrete hydrogen ions or reabsorb bicarbonate adequately. This leads to acid retention and a decrease in blood pH, resulting in metabolic acidosis. This condition is chronic and contributes to complications such as bone demineralization and muscle wasting.

D. Sodium levels in ESRD are usually normal or low. While fluid balance is disrupted, hypernatremia is not a primary lab finding associated with renal failure. Sodium abnormalities are often secondary to fluid retention, diuretic therapy, or dietary intake rather than intrinsic renal dysfunction.

Rationale:

A. Anemia results in reduced oxygen-carrying capacity of the blood due to low red blood cell or hemoglobin levels. This can cause cerebral hypoxia, leading to dizziness, lightheadedness, or even fainting.

B. Fatigue is a hallmark symptom of anemia because tissues receive less oxygen, impairing cellular metabolism and energy production. Clients often report generalized weakness and decreased exercise tolerance.

C. To compensate for decreased oxygen delivery, the body increases respiratory rate, resulting in dyspnea or shortness of breath, particularly during exertion.

D. Anemia typically causes tachycardia as the cardiovascular system attempts to maintain oxygen delivery to tissues. A decreased heart rate is not a typical sign of anemia.

E. Anemia generally leads to pallor, especially of the skin, mucous membranes, and nail beds, rather than redness (erythema). Pallor occurs due to reduced hemoglobin and decreased perfusion.