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Which of the following manifestations are commonly seen in an end stage renal disease patient with fluid overload?

Hypotension

Polyuria

Weight loss

Edema

Answer and Explanation

The Correct Answer is D

A. Hypotension: Fluid overload typically causes hypertension, not hypotension.

B. Polyuria: ESRD patients typically have oliguria or anuria, not excessive urine output.

C. Weight loss: Fluid overload leads to weight gain due to fluid retention.

D. Edema: Fluid overload causes peripheral and pulmonary edema due to impaired kidney function. Clients may also experience hypertension, dyspnea, and crackles.

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Correct Answer is B

Explanation

A. Provide water for a client diagnosed with chronic kidney disease: Fluid intake must be controlled in CKD. A nurse should determine if water intake is appropriate.

B. Instruct the client on appropriate fluid restrictions: Client education is a nursing responsibility and cannot be delegated to a UAP. The nurse should educate clients on fluid restrictions in conditions like chronic kidney disease (CKD) to prevent fluid overload and electrolyte imbalances.

C. Measure the client’s output from the indwelling catheter: This task can be delegated to a UAP.

D. Record the client’s intake and output in the EMR: UAPs can record I&O but cannot interpret the data.

A. Obtain vital signs B. Bolus the client with 1000 m of normal saline C. Turn off the dialysis machine immediately D. Notify the health care provider as soon as possible

Correct Answer is A

Explanation

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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Which of the following manifestations are commonly seen in an end stage renal disease patient with fluid overload?

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