Which of the following are complications the nurse should monitor for during dialysis?
Hyperphosphatemia, a change in the LOC, and dysrhythmias
Dysrhythmias, hypertension, and a change in the LOC
Hypertension, muscle cramping, and nausea
Muscle cramping, dysrhythmias, and hypotension
The Correct Answer is D
A. Hyperphosphatemia, a change in the LOC, and dysrhythmias: Hyperphosphatemia is more a chronic issue in kidney disease, not an acute dialysis complication. While LOC changes and dysrhythmias can occur, the combination is incomplete for typical dialysis complications.
B. Dysrhythmias, hypertension, and a change in the LOC: Hypertension is less common during dialysis; hypotension is more frequently observed due to fluid removal. This combination does not reflect the most common acute complications.
C. Hypertension, muscle cramping, and nausea: Muscle cramping and nausea are relevant, but hypertension is not typical during dialysis. Hypotension, not elevated blood pressure, is a more frequent acute complication.
D. Muscle cramping, dysrhythmias, and hypotension: These are the most common complications during dialysis. Hypotension results from rapid fluid removal, muscle cramping occurs due to fluid and electrolyte shifts, and dysrhythmias can arise from electrolyte imbalances, particularly potassium changes. Monitoring for these ensures client safety.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. 36%: This would overestimate the burned area. The Rule of Nines assigns 18% to the entire anterior trunk and 9% to each entire arm. Only the anterior surfaces are involved here, so this value is too high.
B. 18%: This only accounts for the anterior trunk. The anterior aspects of both arms add additional surface area, so 18% underestimates the total burned area.
C. 30%: This does not accurately sum the anterior surfaces. Each arm’s anterior surface is approximately 4.5%, and the anterior trunk is 18%, totaling less than 30%.
D. 27%: Using the Rule of Nines, the anterior trunk is 18%, and the anterior surfaces of both arms are 4.5% each (total 9%). Adding these together gives 27%.
Correct Answer is A
Explanation
A. ammonia levels: After a bleeding episode in cirrhosis, red blood cell breakdown in the gastrointestinal tract increases nitrogen load, raising the risk of hepatic encephalopathy. Monitoring serum ammonia helps detect early neurotoxicity. Timely identification allows interventions such as lactulose to prevent worsening mental status.
B. potassium levels: Potassium monitoring is important with vasopressin use due to potential electrolyte disturbances, but it does not directly indicate complications from the bleeding episode. Changes in potassium alone are less critical for detecting post-bleeding complications.
C. bilirubin levels: Bilirubin reflects liver function and cholestasis, but short-term elevations after a variceal bleed are not the most immediate complication to monitor. It is more relevant for chronic liver disease monitoring rather than acute bleeding events.
D. creatinine levels: Creatinine is useful for detecting renal impairment, which can occur in advanced cirrhosis, but it does not directly indicate complications from acute variceal bleeding. Renal monitoring is secondary to assessing for hepatic encephalopathy risk.
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