The nurse is teaching a patient who is scheduled for hemodialysis about the process and potential complications. Which of the following statements by the patient indicates to the nurse the need for further teaching? (Select All That Apply)

"I can eat any foods I want before dialysis as long as I don't drink too much fluid."

"I need to report any unusual changes in my access site, like redness or swelling."

"I will need to check my blood pressure regularly to monitor for changes during dialysis."

"I should contact my healthcare provider if I notice swelling in my hands, feet, or ankles."

"I understand that hemodialysis will permanently cure my kidney disease."

Answer and Explanation

Correct Answer : A,E

Choice A reason: Eating any foods before dialysis as long as fluid intake is limited is incorrect. Patients undergoing hemodialysis need to follow specific dietary restrictions to manage electrolyte balance and prevent complications. A renal diet typically limits potassium, phosphorus, and sodium intake, in addition to fluid restrictions.

Choice B reason: Reporting any unusual changes in the access site, like redness or swelling, is correct. Changes at the access site can indicate infection or other complications and require immediate attention.

Choice C reason: Checking blood pressure regularly to monitor for changes during dialysis is correct. Blood pressure monitoring is essential during dialysis to detect hypotension or hypertension and adjust treatment accordingly.

Choice D reason: Contacting the healthcare provider if swelling in hands, feet, or ankles is noticed is correct. Swelling can indicate fluid overload or other complications that need to be addressed.

Choice E reason: Understanding that hemodialysis will permanently cure kidney disease is incorrect. Hemodialysis is a treatment that replaces kidney function but does not cure kidney disease. It manages symptoms and removes waste products from the blood.

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Correct Answer is C

Explanation

Choice A reason: The lab results pH 7.26, PaCO2 59, HCO3 30 indicate respiratory acidosis with partial compensation. This finding is inconsistent with the expected results for a patient with small bowel obstruction and nasogastric suction, which typically leads to metabolic alkalosis due to loss of gastric acid.

Choice B reason: The lab results pH 7.46, PaCO2 30, HCO3 24 suggest a slightly alkaline state with normal bicarbonate levels, which could indicate respiratory alkalosis with compensation. However, for a patient with a small bowel obstruction and nasogastric suction, this is less likely.

Choice C reason: The lab results pH 7.48, PaCO2 42, HCO3 29 indicate metabolic alkalosis. This is a common finding in patients with small bowel obstruction who have been on nasogastric suction, which removes stomach acids and leads to an increase in bicarbonate levels. The elevated pH and bicarbonate levels are consistent with this condition.

Choice D reason: The lab results pH 7.31, PaCO2 34, HCO3 18 indicate metabolic acidosis. This finding is inconsistent with the expected results for a patient with small bowel obstruction and nasogastric suction, which typically leads to

A. "Young people do not have to worry about heart failure, just older people." B. "Progressive kidney failure contributes to the development and severity of heart failure." C. "The elderly patient used cocaine as a teenager and complains of occasional anxiety." D. "The patient takes 20mg of losartan every day and their potassium level is 3.8 mEq/L."

Correct Answer is B

Explanation

Choice A reason: The statement that young people do not have to worry about heart failure, just older people, is incorrect. While heart failure is more common in older adults, it can occur at any age, particularly in individuals with underlying health conditions or risk factors.

Choice B reason: Progressive kidney failure contributes to the development and severity of heart failure. Kidney function and heart function are closely related. When the kidneys are not working properly, they can contribute to fluid retention, increased blood pressure, and additional strain on the heart, leading to heart failure.

Choice C reason: The elderly patient using cocaine as a teenager and complaining of occasional anxiety is less relevant to the immediate risk factors for developing heart failure. While past cocaine use can have long-term cardiovascular effects, occasional anxiety is not a significant contributing factor to heart failure.

Choice D reason: The patient taking 20mg of losartan every day and having a potassium level of 3.8 mEq/L is relevant to managing their heart condition but does not directly address the development of heart failure. Losartan is a medication used to manage blood pressure and heart failure, and the potassium level is within the normal range.

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The nurse is teaching a patient who is scheduled for hemodialysis about the process and potential complications. Which of the following statements by the patient indicates to the nurse the need for further teaching? (Select All That Apply)

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Correct Answer is C

Explanation

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