The client receiving hemodialysis is complaining of being dizzy and light-headed. Which action should the nurse implement first?

Obtain vital signs

Bolus the client with 1000 m of normal saline

Turn off the dialysis machine immediately

Notify the health care provider as soon as possible

Answer and Explanation

The Correct Answer is A

A. Obtain vital signs: Dizziness and lightheadedness during dialysis suggest hypotension, a common complication. The nurse should first assess vital signs to determine the severity before taking further action.

B. Bolus the client with 1000 mL of normal saline: If the client is hypotensive, a smaller fluid bolus (e.g., 250–500 mL) would be more appropriate.

C. Turn off the dialysis machine immediately: Stopping dialysis abruptly may cause fluid overload and other complications. The rate may need adjustment but not immediate cessation.

D. Notify the health care provider as soon as possible: While important, assessing the client’s current status is the priority before contacting the provider.

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Correct Answer is C

Explanation

A. During dialysis: Some drugs can bind to the dialysis membrane or be removed unpredictably.

B. Give as scheduled: If given before dialysis, the drugs may be removed from circulation.

C. After returning from dialysis: Dialysis removes medications from the bloodstream. Giving medications before dialysis may result in drug loss. Oral medications should be given after dialysis to ensure proper absorption and effectiveness.

D. Hold the medications for today and restart tomorrow: Unnecessary, as the client needs their medications post-dialysis.

A. Respiratory Acidosis B. Metabolic Alkalosis C. Respiratory Alkalosis D. Metabolic acidosis

Correct Answer is D

Explanation

A. Respiratory Acidosis: Respiratory acidosis results from inadequate ventilation leading to CO₂ retention, which is unrelated to kidney failure.

B. Metabolic Alkalosis: Metabolic alkalosis occurs due to excessive loss of acids (e.g., vomiting) or excess bicarbonate intake. Acute renal failure causes acid retention, not loss.

C. Respiratory Alkalosis: Respiratory alkalosis is caused by hyperventilation and excessive CO₂ loss, not renal dysfunction.

D. Metabolic acidosis: The kidneys play a vital role in acid-base balance by excreting hydrogen ions and reabsorbing bicarbonate. Acute renal failure impairs these functions, leading to acid retention and metabolic acidosis.

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The client receiving hemodialysis is complaining of being dizzy and light-headed. Which action should the nurse implement first?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is C

Explanation

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Correct Answer is D

Explanation

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