Why would a nurse check a serum creatinine level?

Choice a reason: Body weight is the most accurate measurement for determining fluid losses in clients undergoing hemodialysis. Weighing the client before and after dialysis allows healthcare providers to quantify the exact amount of fluid removed during the treatment. This is critical for managing fluid balance and ensuring the client does not experience excessive fluid removal, which can lead to hypotension and other complications.
Choice b reason: While monitoring blood pressure before and after hemodialysis is essential to assess the client's cardiovascular stability, it is not a direct measure of fluid loss. Blood pressure changes can be influenced by various factors such as fluid status, vascular resistance, and cardiac output, but they do not provide a precise measurement of fluid removal.
Choice c reason: Neck vein distention can indicate fluid overload or changes in intravascular volume, but it is not a precise method for quantifying fluid loss during hemodialysis. Neck vein distention is a subjective assessment and can be influenced by factors such as body position and venous pressure, making it less reliable for determining exact fluid loss.
Choice d reason: Abdominal girth measurement is typically used to assess ascites or abdominal distension, not fluid loss during hemodialysis. It is not a relevant measurement for clients undergoing hemodialysis, as it does not provide information about the volume of fluid removed during the treatment. Abdominal girth changes are more relevant for conditions such as liver disease or gastrointestinal issues.

Choice a reason: The patient uses clean technique when instilling the dialysate is incorrect and requires additional teaching. Peritoneal dialysis requires sterile technique to prevent infection. Using a clean technique, which is less rigorous than sterile technique, increases the risk of introducing pathogens into the peritoneal cavity. Proper sterile technique involves meticulous hand hygiene, using sterile gloves, and ensuring all equipment and supplies are sterile.
Choice b reason: The patient performs exchanges on a table with a sterile drape is appropriate. Using a sterile drape helps maintain a sterile field and reduces the risk of contamination during the dialysis procedure. This practice is an important part of sterile technique and helps ensure the patient's safety.
Choice c reason: The patient verbally expresses symptoms to report to the HCP is a positive behavior. Being aware of and communicating symptoms that may indicate complications, such as signs of infection or peritonitis, is crucial for timely intervention and management. This practice shows the patient is knowledgeable about monitoring their health and knowing when to seek professional help.
Choice d reason: The patient washes their hands before beginning is an essential step in both clean and sterile techniques. Proper hand hygiene is critical in preventing the spread of infection and is a fundamental practice in peritoneal dialysis. Washing hands thoroughly before starting the procedure helps minimize the risk of contamination.