Which laboratory test results should the nurse monitor in a client who has end-stage renal disease (ESRD)?

A. Fluid volume deficit. Gastroenteritis, characterized by fever, chills, anorexia, and diarrhea, can lead to significant fluid loss, especially in an older adult who may already have compromised fluid balance due to other factors such as stroke-related immobility. Fluid volume deficit is a critical problem that requires immediate attention to prevent complications such as hypovolemic shock.
B. Bowel incontinence. While bowel incontinence is a concern, it is not as immediately life- threatening as fluid volume deficit.
C. Caregiver role strain. While important for the client's overall well-being, caregiver role strain is a secondary concern compared to the client's physiological needs.
D. Impaired bed mobility. Impaired bed mobility is a long-term issue that requires attention but is not as urgent as addressing the immediate physiological needs of fluid volume deficit.

• Shaking is lessened: Shaking or tremors can be a manifestation of the body's response to stress or discomfort. A decrease in shaking suggests that the client's physiological response is returning to normal, indicating improvement.
• Client is no longer flushed: Flushing, or the reddening of the skin, can occur as a result of vasodilation during an allergic reaction or due to increased blood flow associated with elevated body temperature. The absence of flushing suggests that the body's inflammatory response has subsided, indicating resolution of the adverse reaction.
• No longer itching: Itching, or pruritus, is a common symptom of allergic reactions mediated by histamine release. The cessation of itching suggests that the inflammatory mediators responsible for the itching response have been cleared from the body, indicating resolution of the allergic reaction.
• Anxiety has decreased: Anxiety can be a psychological response to physical discomfort or distress. A decrease in anxiety levels suggests that the client is experiencing less discomfort and is psychologically improving, which can be indicative of recovery from the adverse drug reaction.
• Skin warm and dry: Warm and dry skin is a sign of normal thermoregulation and hydration status. The presence of warm and dry skin suggests that the client's body temperature andhydration levels are within normal limits, indicating physiological stability and recovery from the adverse drug reaction.
• Heart rate 62 beats/minute, blood pressure 130/72 mm Hg: Vital signs within normal limits, including a heart rate and blood pressure within the client's baseline range, indicate stability of cardiovascular function and resolution of any hemodynamic instability associated with the adverse drug reaction.
• No chest pain noted: Chest pain can be indicative of cardiovascular compromise or ischemia. The absence of chest pain suggests that the client's cardiovascular function has normalized, further supporting recovery from the adverse drug reaction.
• Respirations are even and unlabored: Even and unlabored respirations indicate normal respiratory function and adequate gas exchange. The absence of respiratory distress or effort suggests resolution of any respiratory complications associated with the adverse drug reaction.
• Drowsy: Drowsiness can be a side effect of medications such as antihistamines or a natural response to the body's recovery process. While drowsiness may persist for a period after the adverse drug reaction resolves, its presence alongside other signs of improvement suggests that the client's body is returning to a state of equilibrium.