The client has just undergone surgery for bladder cancer and has an indwelling urinary catheter.
The nurse should monitor for which of the following complications?

This is because acute renal failure is a condition where the kidneys lose their ability to filter waste and excess fluid from the blood. This can lead to fluid overload, electrolyte imbalances, and metabolic acidosis. Therefore, the nurse should monitor the patient’s urine output and fluid balance to assess the severity of the renal impairment and prevent complications.

Choice A is wrong because administering a potassium-sparing diuretic would worsen the patient’s hyperkalemia, which is a common complication of acute renal failure.

Choice B is wrong because encouraging the patient to consume a high-sodium diet would increase the patient’s fluid retention and blood pressure, which can further damage the kidneys.

Choice D is wrong because administering intravenous antibiotics is not a priority intervention for acute renal failure unless there is a specific indication of infection.

Monitoring the client’s electrolyte levels before and after the treatment. This is because acute kidney injury (AKI) can cause electrolyte imbalances such as hyperkalemia, hyperphosphatemia, hypocalcemia, and metabolic acidosis. Hemodialysis can help correct these imbalances by removing excess fluid and waste products from the blood. However, hemodialysis can also cause electrolyte shifts and complications such as hypotension, muscle cramps, and arrhythmias. Therefore, it is important to monitor the client’s electrolyte levels before and after the treatment to assess the effectiveness and safety of hemodialysis.

Choice A is wrong because monitoring the client’s blood pressure every 4 hours is not frequent enough during hemodialysis.

Hemodialysis can cause rapid changes in blood pressure due to fluid removal and vascular access.

Therefore, blood pressure should be monitored more often, such as every 15 to 30 minutes during hemodialysis.

Choice B is wrong because administering a loop diuretic before the treatment is not indicated for AKI patients receiving hemodialysis.

Loop diuretics are used to increase urine output and reduce fluid overload in AKI patients who have some residual kidney function.

However, hemodialysis can achieve the same goal by removing excess fluid from the blood.

Moreover, loop diuretics can cause electrolyte depletion and ototoxicity, which can worsen the condition of AKI patients.

Choice C is wrong because assessing the client’s respiratory status every 2 hours is not specific enough for hemodialysis treatment.

Hemodialysis can affect respiratory mechanics by altering fluid balance, acid- base status, and oxygen delivery.

Therefore, respiratory status should be assessed more frequently and comprehensively during hemodialysis, such as by measuring respiratory rate, oxygen saturation, arterial blood gas, and chest auscultation.