A)This statement is incorrect. Hemodialysis does not use the peritoneal membrane as a filter. Hemodialysis involves the use of a machine that filters the blood outside the body, not the peritoneal membrane.

B) This statement is incorrect. Continuous ambulatory peritoneal dialysis (CAPD) uses the peritoneal membrane as a filter during manual exchanges of dialysate fluid, not with a machine like automated peritoneal dialysis (APD).

C) This statement is accurate. Automated peritoneal dialysis (APD) uses a machine to perform exchanges of dialysate solution through the peritoneal membrane.

D) This statement is incorrect. Peritoneal dialysis uses the peritoneal membrane as a filter. It involves the instillation and drainage of dialysate fluid into the abdominal cavity through a catheter.

A) The client's symptoms of dizziness and weakness may indicate hypotension (low blood pressure). The nurse should first check the client's blood pressure and pulse rate to assess for hypotension before implementing further interventions.

B) This statement is incorrect. Administering an antiemetic medication would not address the reported symptoms of dizziness and weakness, which may be related to changes in blood pressure.

C) This statement is incorrect. Increasing the rate of fluid removal during dialysis may exacerbate the client's symptoms of dizziness and weakness and may lead to hypotension (low blood pressure).

D) This statement is incorrect. Elevating the client's legs may help improve blood flow, but it does not address the underlying cause of the reported symptoms. The nurse should first check the client's blood pressure and pulse rate to assess for hypotension before implementing further interventions.

A) This statement is incorrect. The catheter dressing should be changed regularly as per the healthcare provider's instructions, but it is not typically changed every week.

B) This statement is incorrect. The routine use of antibiotic ointment is not recommended, as it can lead to antibiotic resistance and is not necessary for all clients on peritoneal dialysis.

C) To reduce the risk of infection, the client should avoid touching the catheter site with clean hands. Maintaining proper hand hygiene is essential to prevent infection.

D) This statement is incorrect. Cleaning the catheter site with hydrogen peroxide is not recommended, as it can be too harsh and irritating to the skin. Instead, the site should be cleaned with mild soap and water or as instructed by the healthcare provider.

A) This statement is incorrect. Increasing the dialysis session duration would not address the client's muscle cramps and may lead to further fluid and electrolyte imbalances.

B) Muscle cramps during hemodialysis can be caused by the cooling effect of the dialysate solution. Increasing the temperature of the dialysate can help alleviate the cramps.

C) This statement is incorrect. Decreasing the dialysate solution flow rate may not directly address the muscle cramps and may not be indicated unless there are other clinical indications to do so.

D) This statement is incorrect. Administering an anticoagulant medication is not relevant to address muscle cramps. Muscle cramps during hemodialysis are often caused by the cooling effect of the dialysate solution. Increasing the temperature of the dialysate can help alleviate the cramps.

A) This statement is incorrect. Erythropoietin-stimulating agents (ESAs) are not used to prevent infections during dialysis. They are used to address anemia by stimulating red blood cell production.

B) This statement is accurate. Erythropoietin-stimulating agents (ESAs) stimulate the bone marrow to produce more red blood cells, addressing anemia commonly associated with chronic kidney disease and dialysis.

C) This statement is incorrect. Erythropoietin-stimulating agents (ESAs) do not reduce the risk of blood clot formation. They are specific to stimulating the production of red blood cells.

D) This statement is incorrect. Erythropoietin-stimulating agents (ESAs) do not enhance kidney function and filtration. They target the production of red blood cells to address anemia associated with ESRD and dialysis.

A) This statement is incorrect. Cloudy dialysate drainage may indicate infection or peritonitis, and the nurse should not simply document the finding and continue monitoring without further assessment.

B) This statement is incorrect. Administering an antibiotic medication without a definitive diagnosis is not appropriate. The nurse should assess the client further to determine the cause of the cloudy drainage.

C) This statement is incorrect. Increasing the dialysis exchange frequency would not address the issue of cloudy dialysate drainage and may not be indicated without a proper assessment.

D) This statement is correct. Cloudy dialysate drainage may indicate infection or peritonitis. The nurse should check the client's vital signs and assess for signs of abdominal pain or tenderness, as this requires immediate evaluation.

A) This statement is accurate. Clients on hemodialysis should limit their protein intake to reduce the workload on the kidneys and minimize waste buildup. Excess protein intake can lead to the accumulation of urea and other waste products, which can be challenging for the compromised kidneys to eliminate.

B) This statement is incorrect. While clients on hemodialysis may need to limit sodium intake to manage fluid retention and blood pressure, the primary nutrient that requires limitation in their diet is protein.

C) This statement is incorrect. Clients on hemodialysis may need to monitor their calcium intake, but it is not the primary nutrient that requires limitation in their diet. Calcium levels may be affected by the use of phosphate binders and the avoidance of high-phosphorus foods, but protein restriction is more critical.

D) This statement is incorrect. Iron intake may need to be managed for clients with anemia, which is common in end-stage renal disease (ESRD) and dialysis. However, protein restriction remains a more significant dietary consideration for clients on hemodialysis.

QUESTIONS

A) This statement is incorrect. Hypertension (high blood pressure) is a common complication of kidney disease, but it is not the primary indication for initiating dialysis. Dialysis is primarily indicated to address the impaired filtration and waste removal functions of the kidneys, which can lead to electrolyte imbalances like hyperkalemia.

B) This statement is incorrect. Hypercalcemia (elevated calcium levels) is not a primary indication for initiating dialysis. While calcium imbalances can be associated with kidney disease, hyperkalemia takes precedence as a more critical indication for dialysis initiation.

C) This statement is accurate. Hyperkalemia (elevated potassium levels) is a critical indication for initiating dialysis. Dialysis helps remove excess potassium from the bloodstream when the kidneys are unable to do so, preventing potentially life-threatening complications.

D) This statement is incorrect. Hypokalemia (low potassium levels) is not an indication for initiating dialysis. In fact, dialysis may lead to a reduction in potassium levels, and clients on dialysis are more likely to experience hyperkalemia.

A) This statement is incorrect. Dialysis does not restore normal kidney function. Instead, it serves as a substitute for impaired kidney function, helping to maintain fluid and electrolyte balance.

B) This statement is incorrect. Dialysis is not a surgical procedure to transplant a healthy kidney. Kidney transplantation is a separate procedure that involves replacing a damaged kidney with a healthy one from a living or deceased donor.

C) This statement is incorrect. Dialysis may help manage complications of CKD and prolong life, but it does not prevent the progression of the underlying kidney disease. CKD is a chronic and progressive condition that may eventually require dialysis or kidney transplantation.

D) This statement is accurate. Dialysis is the process of removing waste products, excess fluids, and toxins from the blood when the kidneys are no longer able to perform these functions adequately.

A) This statement is incorrect. Hypokalemia (low potassium levels) is not an indication for initiating dialysis. In AKI, electrolyte imbalances can occur, but hyperkalemia is more likely due to impaired kidney function.

B) This statement is incorrect. Hyponatremia (low sodium levels) is not a primary indication for initiating dialysis in AKI. It can occur due to fluid shifts, but the primary concern in AKI is the accumulation of waste products like urea, leading to uremia.

C) This statement is incorrect. Hypernatremia (high sodium levels) is not a primary indication for initiating dialysis in AKI. Hypernatremia is rare in AKI and usually occurs when there is a significant loss of free water compared to sodium intake.

D) Uremia, which is characterized by elevated levels of urea and other waste products in the blood, is a critical indication for initiating dialysis in clients with acute kidney injury. Dialysis helps remove these toxic substances from the bloodstream.

A) This statement is incorrect. Hypermagnesemia (elevated magnesium levels) can be a concern in ESRD, but it is not a primary indication for initiating dialysis. Magnesium levels can be managed through dietary restrictions and medications without the need for dialysis.

B) This statement is incorrect. Hyperphosphatemia (elevated phosphorus levels) is a common issue in ESRD, but it is not a primary indication for initiating dialysis. Clients with ESRD may receive phosphate binders to control phosphorus levels without necessarily needing immediate dialysis.

C) This statement is incorrect. Hyperkalemia (elevated potassium levels) is a concern in ESRD, but it is not the primary indication described in the scenario. While hyperkalemia may occur with fluid overload, the primary concern in this case is the hypervolemia and its associated symptoms.

D) Hypervolemia (severe fluid overload) is a critical indication for initiating dialysis in clients with end-stage renal disease. Dialysis helps remove excess fluid from the body and can relieve symptoms such as pulmonary edema and hypertension.

A) This statement is incorrect. Hypernatremia (high sodium levels) is not the primary indication for initiating dialysis in this case. Metabolic acidosis and the inability of the kidneys to excrete acids are the primary concerns.

B) This statement is incorrect. Hyperkalemia (elevated potassium levels) may occur in CKD, but it is not the primary indication described in the scenario. Metabolic acidosis is the primary concern leading to the need for dialysis.

C) This statement is incorrect. Hypocalcemia (low calcium levels) can be a complication of CKD, but it is not the primary indication for initiating dialysis in this scenario. Metabolic acidosis and its associated symptoms take precedence.

D) Severe metabolic acidosis, which results from the kidneys' inability to adequately excrete acids and regulate pH balance, is a critical indication for initiating dialysis in clients with CKD.

A) This statement is incorrect. Hypercalcemia (elevated calcium levels) can be a concern in ESRD, but it is not the primary indication for initiating dialysis in this scenario. Pruritus is more commonly associated with uremia and high levels of other waste products.

B) This statement is incorrect. Hypervolemia (fluid overload) can be a concern in ESRD, but it is not the primary indication described in the scenario. The persistent pruritus is more likely related to uremia and the accumulation of toxins.

C) This statement is incorrect. Hyperkalemia (elevated potassium levels) is not the primary indication described in the scenario. While hyperkalemia may occur in ESRD, the primary concern leading to the need for dialysis in this case is the uremia and its associated symptoms.

D) Uremia, which is the accumulation of urea and other waste products in the blood, can lead to various complications, including pruritus. Dialysis helps remove these waste products from the bloodstream and may alleviate the itching associated with uremia.

A) This statement is incorrect. Hypoglycemia (low blood glucose) is not the primary indication for initiating dialysis. Hypoglycemia can occur in certain situations, but it is not the primary concern in this case.

B) This statement is incorrect. Hyperkalemia (elevated potassium levels) can be a concern in AKI, but it is not the primary indication described in the scenario. The primary concern in AKI with decreased GFR is the impaired filtration and waste removal, leading to the need for dialysis.

C) This statement is incorrect. Hypernatremia (high sodium levels) is not a primary indication for initiating dialysis in AKI. Hypernatremia is rare in AKI and usually occurs when there is a significant loss of free water compared to sodium intake.

D) A significantly decreased glomerular filtration rate (GFR) indicates that the kidneys' ability to filter waste products and excess fluids from the blood is severely impaired. Dialysis can help support kidney function and remove waste products when the GFR is critically low.

A) This statement is incorrect. Hyperkalemia (elevated potassium levels) can be a concern in ESRD, but it is not the primary indication described in the scenario. While hyperkalemia may occur in ESRD, the primary concern leading to the need for dialysis is the uremia and its associated symptoms.

B) This statement is incorrect. Hypophosphatemia (low phosphorus levels) can be a concern in ESRD, but it is not the primary indication for initiating dialysis in this case. Uremia and its associated symptoms are the primary concerns leading to the need for dialysis.

C) Uremia, which is characterized by elevated levels of urea and other waste products in the blood, is a critical indication for initiating dialysis in clients with end-stage renal disease. Dialysis helps remove these toxic substances from the bloodstream and may alleviate symptoms like fatigue, weakness, and decreased urine output.

D) This statement is incorrect. Hyponatremia (low sodium levels) is not the primary indication for initiating dialysis in this scenario. Uremia and the accumulation of waste products are the primary concerns that require dialysis to address.

QUESTIONS

A) This statement is incorrect. Hemodialysis does not involve the removal of the peritoneal membrane; that description is characteristic of peritoneal dialysis.

B) This statement is accurate. Hemodialysis uses a machine called a dialyzer to filter blood outside the body, removing waste products and excess fluid before returning the clean blood to the patient.

C) This statement is incorrect. Hemodialysis does not rely on a catheter inserted into the bladder; that description is characteristic of urinary catheterization.

D) This statement is incorrect. Hemodialysis does not use a pump to circulate dialysate through the intestines; that description is characteristic of peritoneal dialysis.

A) This statement is incorrect. Increasing the rate of fluid removal during dialysis may worsen the client's symptoms of lightheadedness and dizziness, as it can lead to further drops in blood pressure.

B) This statement is incorrect. Administering an antihypertensive medication is not appropriate in this situation, as the client is experiencing symptoms of low blood pressure, not high blood pressure.

C) This statement is accurate. Feeling lightheaded and dizzy during hemodialysis may be a sign of hypotension (low blood pressure), and the nurse should assess the client's blood pressure and pulse rate to determine if intervention is needed.

D) This statement is incorrect. Elevating the client's legs may promote blood flow, but it does not address the immediate issue of lightheadedness and dizziness. Assessing the client's blood pressure and pulse rate is the priority to determine the appropriate intervention.

A) This statement is accurate. Clients on hemodialysis should limit their protein intake to reduce the workload on the kidneys and minimize waste buildup. Excess protein intake can lead to the accumulation of urea and other waste products, which can be challenging for the compromised kidneys to eliminate.

B) This statement is incorrect. While clients on hemodialysis may need to limit sodium intake to manage fluid retention and blood pressure, the primary nutrient that requires limitation in their diet is protein.

C) This statement is incorrect. Clients on hemodialysis may need to monitor their calcium intake, but it is not the primary nutrient that requires limitation in their diet. Calcium levels may be affected by the use of phosphate binders and the avoidance of high-phosphorus foods, but protein restriction is more critical.

D) This statement is incorrect. Iron intake may need to be managed for clients with anemia, which is common in end-stage renal disease (ESRD) and dialysis. However, protein restriction remains a more significant dietary consideration for clients on hemodialysis.

A) This statement is incorrect. Increasing the dialysis session duration would not address the client's muscle cramps and may lead to further fluid and electrolyte imbalances.

B) This statement is accurate. Muscle cramps during hemodialysis are often caused by the cooling effect of the dialysate solution. Increasing the temperature of the dialysate can help alleviate the cramps.

C) This statement is incorrect. Decreasing the dialysate solution flow rate may not directly address the muscle cramps and may impact the effectiveness of the dialysis treatment.

D) This statement is incorrect. Administering an anticoagulant medication is not indicated for muscle cramps during hemodialysis. Anticoagulants are used to prevent blood clots during the procedure but would not alleviate muscle cramps.

A)This statement is incorrect. Administering an analgesic for the headache may provide temporary relief, but it does not address the underlying issue of fluid overload and elevated blood pressure.

B) This statement is incorrect. Notifying the healthcare provider about the blood pressure changes is important, but assessing for fluid overload and taking appropriate actions should be the nurse's priority.

C) This statement is accurate. Headache and restlessness during hemodialysis, along with elevated blood pressure, may indicate fluid overload. The nurse should assess the client's weight and fluid intake during the dialysis session to determine if there is excessive fluid retention.

D) This statement is incorrect. Increasing the dialysate solution flow rate may not be appropriate without further assessment of the client's fluid status. It could worsen the fluid overload and further increase blood pressure.

A) This statement is incorrect. Serum calcium levels are not directly related to ESA therapy for anemia management. ESA therapy focuses on increasing red blood cell production.

B) This statement is incorrect. Blood urea nitrogen (BUN) levels are indicators of kidney function and may be monitored for other reasons in a client on hemodialysis. However, they are not directly related to ESA therapy for anemia management.

C) This statement is accurate. During ESA therapy, the nurse should closely monitor the client's hemoglobin and hematocrit levels. ESAs stimulate the production of red blood cells and can increase hemoglobin and hematocrit levels. Regular monitoring is essential to prevent anemia or excessive increases in these values.

D) This statement is incorrect. Serum potassium levels may be monitored for a client on hemodialysis due to the potential for electrolyte imbalances, but they are not the primary concern during ESA therapy for anemia management.

A) This statement is accurate. Palpating for a thrill or vibration over the AV fistula site is a critical assessment to ensure proper functioning. A thrill indicates adequate blood flow through the fistula, which is essential for effective hemodialysis.

B) This statement is incorrect. Auscultating for bruits over the radial artery is not related to the AV fistula assessment. The bruit is the sound of blood flow in the fistula, which is best assessed directly over the fistula site.

C) This statement is incorrect. Checking for distal pulses in the lower extremities is not related to the assessment of an AV fistula. The AV fistula is typically created in the upper extremity.

D) This statement is incorrect. Assessing for swelling and tenderness in the neck is not related to the AV fistula assessment. Swelling and tenderness may be related to other issues but are not specific to AV fistula functioning.

A) This statement is incorrect. Monitoring hemoglobin levels is essential for clients with ESRD and during hemodialysis, but it is not directly related to the administration of heparin.

B) This statement is accurate. While a drop in platelet count is not uncommon during heparin administration, the nurse should closely monitor the client's platelet count to detect any significant changes or potential complications related to heparin-induced thrombocytopenia.

C) This statement is incorrect. Monitoring blood glucose levels is important, especially for clients with diabetes or those at risk of hypoglycemia during dialysis, but it is not specifically related to heparin administration.

D) This statement is incorrect. Monitoring blood urea nitrogen (BUN) levels is crucial for clients with ESRD, but it is not directly related to the administration of heparin during hemodialysis.

QUESTIONS

A) This statement is incorrect. Peritoneal dialysis does not use a machine to filter blood outside of the body; that description is characteristic of hemodialysis.

B) This statement is incorrect. Peritoneal dialysis does not involve the removal of the peritoneal membrane; instead, it uses the peritoneal membrane in the abdomen to filter waste.

C) This statement is accurate. Peritoneal dialysis uses the peritoneal membrane in the abdomen as a semipermeable membrane to filter waste products and excess fluids from the blood.

D) This statement is incorrect. Peritoneal dialysis does not require a catheter to be inserted into the bladder. Instead, it uses a catheter to infuse and drain dialysate into and out of the peritoneal cavity.

A) This statement is incorrect. While administering an antibiotic may be necessary if peritonitis is confirmed, it should not be done without obtaining a sample for testing first.

B) This statement is incorrect. Measuring vital signs and assessing for pain are essential aspects of client assessment, but they may not provide enough information to determine the cause of the cloudy drainage.

C) This statement is incorrect. Clamping the catheter may be necessary if peritonitis is suspected, but it should not be done without first obtaining a sample of the drainage for testing.

D) This statement is accurate. Cloudy drainage from the catheter site may indicate peritonitis, which is an infection of the peritoneal cavity. Obtaining a sample of the drainage for culture and sensitivity testing can help identify the presence of infection and guide appropriate treatment.

A) This statement is incorrect. Serum calcium levels are not directly related to ESA therapy for anemia management. ESA therapy focuses on increasing red blood cell production.

B) This statement is incorrect. Blood urea nitrogen (BUN) levels are indicators of kidney function and may be monitored for other reasons in a client on peritoneal dialysis. However, they are not directly related to ESA therapy for anemia management.

C) This statement is accurate. During ESA therapy, the nurse should closely monitor the client's hemoglobin and hematocrit levels. ESAs stimulate the production of red blood cells and can increase hemoglobin and hematocrit levels. Regular monitoring is essential to prevent anemia or excessive increases in these values.

D) This statement is incorrect. Serum potassium levels may be monitored for a client on peritoneal dialysis due to the potential for electrolyte imbalances, but they are not the primary concern during ESA therapy for anemia management.

A) This statement is incorrect. Infection is not a rare complication of peritoneal dialysis. It is a common risk that requires proactive measures to prevent.

B) This statement is incorrect. While infections can occur and may be treatable with antibiotics, it is essential to focus on prevention and maintaining aseptic technique.

C) This statement is incorrect. Taking antibiotics regularly to prevent infection is not the standard practice for clients on peritoneal dialysis. Antibiotics are typically prescribed to treat infections when they occur, not as a preventive measure.

D) This statement is accurate. Infection is a significant risk for clients on peritoneal dialysis due to the direct access to the peritoneal cavity through the catheter. Strict aseptic technique is crucial to prevent infections.

A) This statement is incorrect. Administering an analgesic for the abdominal pain may provide temporary relief, but it does not address the underlying cause of the symptoms.

B) This statement is incorrect. Measuring blood pressure and pulse rate is essential for client assessment, but it may not provide enough information to determine the cause of the symptoms.

C) This statement is accurate. Abdominal pain and fever in a client on peritoneal dialysis may indicate peritonitis, which can result from infection or catheter issues. The nurse should first check the catheter for kinks or obstructions to ensure proper drainage and prevent complications.

D) This statement is incorrect. Notifying the healthcare provider about the symptoms is important, but the nurse should first assess the catheter for possible issues to determine if immediate intervention is needed.

A) This statement is incorrect. Peritoneal dialysis does not require extended hospital stays, as it can be performed at home.

B) This statement is incorrect. While some modifications to daily activities may be necessary, peritoneal dialysis does not generally require clients to limit their daily activities or avoid physical exertion.

C) This statement is accurate. Peritoneal dialysis is a form of dialysis that can be performed by the client at home, allowing them to continue with their daily activities without the need for hospitalization or daily clinic visits.

D) This statement is incorrect. Peritoneal dialysis is performed by the client at home, not at the outpatient clinic every day. The client may visit the clinic for periodic follow-up and assessment, but the actual dialysis is performed at home.

A) This statement is accurate. Hypertonic dialysate has a higher concentration of glucose, which results in increased fluid removal from the client's peritoneal cavity. This type of dialysate is often used for more effective ultrafiltration.

B) This statement is incorrect. Infusing hypertonic dialysate does not result in decreased urine output. Peritoneal dialysis is a process of exchanging fluids and waste products through the peritoneal membrane, but it does not directly affect urine production.

C) This statement is incorrect. Infusing hypertonic dialysate would not lead to hydration overload, as it causes fluid to be removed from the body.

D) This statement is incorrect. Hypertonic dialysate would not cause hypotension. In fact, it may lead to a decrease in blood pressure due to fluid removal, but it would not be considered a primary cause of hypotension.

A) This statement is incorrect. Increasing the intake of potassium-rich foods is not related to managing constipation. In fact, clients on peritoneal dialysis may need to restrict potassium intake due to the potential for electrolyte imbalances.

B) This statement is accurate. Constipation can be a common issue for clients on peritoneal dialysis due to the presence of glucose in the dialysate, which can draw fluid into the peritoneal cavity and lead to decreased bowel movement. Administering a stool softener as needed can help alleviate constipation.

C) This statement is incorrect. Decreasing fluid intake during dialysis is not recommended for managing constipation. Fluid intake should be maintained as prescribed to achieve adequate ultrafiltration.

D) This statement is incorrect. Encouraging the client to consume dairy products is not directly related to managing constipation. While calcium intake may be important for bone health in clients with ESRD, it is not a primary intervention for constipation.

QUESTIONS

A. Incorrect. Protein intake is essential for maintaining body functions, but clients on dialysis may need to adjust their protein intake based on their individual needs and dialysis prescription.

B. Incorrect. Clients on dialysis may need to limit their sodium intake to manage fluid retention and blood pressure.

C. Correct. Clients on dialysis often need to avoid potassium-rich foods to prevent hyperkalemia, as the kidneys are unable to adequately remove excess potassium from the blood.

D. Incorrect. Clients on dialysis typically need to restrict their phosphorus intake to prevent complications related to high phosphorus levels, such as bone disease and cardiovascular issues.

A. Correct. Monitoring the client's blood pressure and heart rate is a priority during dialysis to assess the client's hemodynamic status and detect any potential complications, such as hypotension or arrhythmias.

B. Incorrect. While assisting with dietary s is important, it is not the priority during the dialysis procedure.

C. Incorrect. Providing emotional support is essential, but the nurse's priority during dialysis is to monitor the client's vital signs and ensure their safety during the procedure.

D. Incorrect. Administering prescribed intravenous medications may be necessary during dialysis, but it is not the priority action stated in this question.

A. Incorrect. Using sterile technique when handling the catheter is essential to prevent infection. Clients and caregivers should be taught the proper aseptic technique for catheter care.

B. Incorrect. Alcohol wipes can dry out the skin and are not recommended for cleaning the catheter insertion site. A more appropriate solution is provided in the correct answer.

C. Correct. Changing the dressing over the catheter daily using clean gloves helps maintain a clean and dry site, reducing the risk of infection during peritoneal dialysis.

D. Incorrect. The catheter should not be immersed in water during bathing or showering, as this can introduce pathogens and increase the risk of infection.

A. Incorrect. Limiting fluid intake is important for some clients with renal issues, but clients on dialysis typically need to maintain adequate hydration due to fluid removal during the procedure.

B. Correct. Clients on dialysis often need to consume plenty of fluids to compensate for the fluid removal that occurs during dialysis treatment, preventing dehydration and maintaining hemodynamic stability.

C. Incorrect. Increasing salt intake is not recommended for clients on dialysis, as it can contribute to fluid retention and worsen hypertension.

D. Incorrect. Limiting fluid intake only on the day of dialysis treatment is not sufficient to maintain overall hydration and may lead to imbalances and complications between dialysis sessions.

A. Correct. Avoiding heavy lifting can help prevent trauma or dislodgement of the peritoneal catheter, which can be a risk factor for infection or complications.

B. Correct. Cleaning the catheter exit site with soap and water daily helps maintain cleanliness and reduce the risk of infection.

C. Incorrect. The dressing around the catheter insertion site should be changed more frequently than weekly, ideally every 2-3 days, to ensure proper hygiene and reduce the risk of infection.

D. Correct. Notifying the healthcare provider about any redness or drainage at the catheter site is essential, as these can be signs of infection or other complications that require prompt evaluation and treatment.

A. Incorrect. Warming the dialysate fluid to body temperature before instilling it into the peritoneal cavity is a standard procedure in continuous ambulatory peritoneal dialysis (CAPD. .

B. Correct. Performing the exchanges in a clean, dry environment free from pets is crucial to prevent contamination and reduce the risk of infection during CAPD.

C. Incorrect. Using tap water to cleanse the catheter insertion site before the exchange is not recommended. The catheter exit site should be cleaned with an appropriate antiseptic solution as instructed by the healthcare provider.

D. Incorrect. While daily dressing changes are important, using sterile technique for catheter dressing changes may not be necessary, as the dressing does not directly contact the peritoneal cavity during CAPD exchanges.

A. Correct. Using the arm with the AV fistula for blood pressure measurements can compress the vascular access and compromise blood flow. It is important to avoid using the fistula arm for blood pressure measurements and venipuncture.

B. Incorrect. The AV fistula should not be used for intravenous catheter insertion to prevent potential damage and infection to the access site.

C. Incorrect. Self-cannulation of the AV graft is typically performed by healthcare professionals, and clients should not attempt to self-cannulate their vascular access.

D. Incorrect. If an AV fistula starts bleeding, the client should not apply pressure to the site. Instead, they should immediately elevate the arm and apply pressure to the bleeding site with a clean cloth or bandage while seeking medical attention.

QUESTIONS

A. Incorrect. Increasing the dialysate temperature can lead to vasodilation and potentially exacerbate hypotension during dialysis.

B. Correct. Limiting fluid removal during dialysis is essential to prevent excessive fluid loss, which can cause hypotension and potentially lead to intradialytic hypotension.

C. Incorrect. Encouraging a high-sodium diet is not the primary intervention to prevent dialysis-related hypotension. It may be recommended for some clients to manage hyponatremia, but fluid management is more critical.

D. Incorrect. Administering intravenous hypertonic saline during dialysis is not a routine intervention to prevent hypotension. It may be used in specific cases, but fluid management is the primary approach.

A. Incorrect. Collecting a sample of the effluent for culture and sensitivity testing may be necessary, but notifying the healthcare provider about the finding should be done first.

B. Incorrect. Stopping the exchange immediately may be necessary in some cases, but the nurse should first communicate the finding to the healthcare provider for further assessment and guidance.

C. Correct. Cloudy dialysate effluent may indicate peritonitis, an infection of the peritoneal cavity, which requires immediate attention and treatment by the healthcare provider.

D. Incorrect. Encouraging the client to perform another exchange without further assessment can potentially exacerbate any underlying issue causing the cloudy effluent.

A. Incorrect. While administering an antiepileptic medication may be necessary if the client is experiencing seizures, it is essential to identify the underlying cause first.

B. Correct. The client's severe headache, confusion, and seizures may be indicative of dialysis disequilibrium syndrome, which is a complication of rapid solute removal during hemodialysis. Hypoglycemia can also present with similar symptoms, so assessing blood glucose levels is crucial to differentiate between the two conditions.

C. Incorrect. Documenting the findings and monitoring the client's condition are important, but addressing the acute symptoms and potential cause should be the priority.

D. Incorrect. Checking the client's pre-dialysis weight is not the priority when the client is experiencing severe neurological symptoms. Immediate assessment and intervention are needed.

A. Incorrect. Administering a calcium channel blocker is not the first-line intervention for muscle cramps during dialysis.

B. Incorrect. Slowing down the blood flow rate during dialysis may be necessary in some cases, but it is not the first action to address muscle cramps.

C. Correct. Muscle cramps during dialysis can be caused by electrolyte imbalances, such as low potassium levels. Offering the client a sports drink with electrolytes can help alleviate the cramps.

D. Incorrect. Applying a heating pad to the affected muscles is not recommended during dialysis, as it may cause burns or worsen the cramps.

A. Incorrect. Administering a prescribed analgesic may be necessary, but it is not the priority when the client is experiencing sudden chest pain and dyspnea.

B. Correct. The sudden onset of chest pain and dyspnea can be indicative of potential complications, such as dialysis-related hypotension, cardiac issues, or fluid overload. Assessing the client's blood pressure and heart rate is the priority to identify any acute changes or abnormalities.

C. Incorrect. Monitoring the client's weight is important to assess fluid status, but it is not the immediate priority when the client presents with acute chest pain and dyspnea.

D. Incorrect. Placing the client in a semi-Fowler's position may be appropriate for respiratory distress, but the nurse should first assess the client's vital signs and overall condition before implementing positioning changes.

A. Incorrect. Instructing the client to increase fluid intake may not address the underlying cause of abdominal pain and fever in a client on peritoneal dialysis.

B. Incorrect. Assisting the client with a peritoneal fluid exchange is not the priority when the client is experiencing abdominal pain and fever, as it may exacerbate the symptoms.

C. Incorrect. Administering an over-the-counter pain reliever may provide temporary relief, but it does not address the underlying cause of the symptoms.

D. Correct. Abdominal pain and fever in a client on peritoneal dialysis may indicate peritonitis, an infection of the peritoneal cavity. Obtaining a peritoneal fluid sample for testing is essential to confirm the diagnosis and initiate appropriate treatment promptly.

A. Incorrect. Offering hard candies or mints may provide temporary relief from the metallic taste, but it does not address the underlying cause.

B. Correct. A persistent metallic taste in the mouth can be caused by various factors, such as dietary changes, medication side effects, or biochemical imbalances. Assessing the client's recent dietary and medication changes can help identify the potential cause.

C. Incorrect. Providing an oral rinse may offer temporary relief, but it does not address the underlying cause of the metallic taste.

D. Incorrect. Administering an antiemetic medication is not indicated for a metallic taste in the mouth, as it is not associated with nausea or vomiting.

A. Correct. Applying pressure to the bleeding site is the first action to control the bleeding and prevent excessive blood loss.

B. Incorrect. Elevating the arm above heart level may not be effective in controlling bleeding from the access site and could cause unnecessary discomfort.

C. Incorrect. Administering a prescribed antiplatelet medication is not the first action to take when the client experiences bleeding from the access site, as it may further increase bleeding risk.

D. Incorrect. While checking the client's platelet count is important, it is not the first action to address active bleeding. Applying pressure to the bleeding site takes priority to control the bleeding.

QUESTIONS

A. Correct. Nephrotic syndrome is characterized by increased protein loss in the urine, leading to hypoalbuminemia and a weakened immune system. Clients with nephrotic syndrome are at a higher risk of infection, so the priority nursing intervention is to assess for signs of infection and initiate appropriate treatment promptly.

B. Incorrect. While monitoring blood glucose levels is essential in some conditions, it is not the priority for a client with nephrotic syndrome.

C. Incorrect. Dietary education may be necessary, but increasing protein intake is not appropriate for clients with nephrotic syndrome due to the increased protein loss in the urine.

D. Incorrect. Diuretics may be used to manage edema in nephrotic syndrome, but the priority intervention is to assess for infection, as it poses a more immediate threat to the client's health.

A. Incorrect. Corticosteroids should be taken with food to reduce the risk of gastrointestinal side effects.

B. Incorrect. While corticosteroids may improve proteinuria over time, it is unlikely to see an immediate improvement after starting the medication.

C. Correct. Corticosteroids can suppress the immune system and increase the risk of infection, so the client should avoid crowded places and contact with individuals who are sick to minimize the risk of infections.

D. Incorrect. Corticosteroids do not specifically affect potassium levels, so there is no need for a diet high in potassium to offset potential electrolyte imbalances.

A. Incorrect. Restricting fluid intake may not be appropriate for clients with nephrotic syndrome, as they may already have reduced fluid intake due to decreased glomerular filtration.

B. Incorrect. Elevating the client's legs can help reduce edema, but a low-sodium diet is a more direct and essential intervention for managing fluid retention in nephrotic syndrome.

C. Correct. A low-sodium diet is crucial in managing edema in nephrotic syndrome. Sodium intake can lead to fluid retention, and reducing sodium intake helps decrease edema.

D. Incorrect. Monitoring blood glucose levels is important for clients with diabetes, but it is not directly related to managing edema in nephrotic syndrome.

A. Incorrect. Frothy, foamy urine is not characteristic of increased glucose levels in the urine.

B. Incorrect. While blood in the urine may cause changes in urine color, it does not result in frothy, foamy appearance.

C. Correct. Nephrotic syndrome is characterized by increased protein excretion in the urine (proteinuriA. . The presence of protein in the urine can cause it to appear frothy and foamy.

D. Incorrect. Creatinine levels reflect kidney function, but they do not cause changes in urine appearance.

A. Correct. ACE inhibitors are commonly prescribed in nephrotic syndrome to reduce proteinuria by dilating blood vessels and decreasing pressure in the glomerulus. This helps preserve kidney function and slow the progression of kidney damage.

B. Incorrect. ACE inhibitors are not primarily used to manage blood glucose levels in diabetes, although they may have some impact on blood pressure control in clients with both diabetes and nephrotic syndrome.

C. Incorrect. ACE inhibitors do not directly impact calcium absorption or bone health in nephrotic syndrome.

D. Incorrect. ACE inhibitors do not specifically increase potassium excretion. In fact, they may lead to potassium retention, so clients may need to be cautious about potassium intake while on ACE inhibitors.

A. Correct. Diuretics can lead to potassium loss, potentially causing hypokalemia. Monitoring serum potassium levels is essential to prevent complications related to potassium imbalances.

B. Incorrect. Diuretics may affect blood glucose levels indirectly, but their primary impact is not related to glucose control.

C. Incorrect. Diuretics do not directly impact calcium levels

in nephrotic syndrome.

D. Incorrect. While monitoring blood pressure is important in nephrotic syndrome, it is not the primary focus when clients are on diuretic therapy.

A. Incorrect. While increased proteinuria can increase the risk of clot formation in the urinary tract, anticoagulant therapy is not typically prescribed for this reason in nephrotic syndrome.

B. Incorrect. Anticoagulants are not primarily used to reduce inflammation and pain associated with kidney damage.

C. Incorrect. Anticoagulants do not directly impact the risk of infection related to hypoalbuminemia.

D. Correct. Nephrotic syndrome can cause damage to the glomerular capillaries, leading to clot formation. Anticoagulant therapy is prescribed to prevent clot formation in the kidneys and reduce the risk of complications such as renal vein thrombosis.

QUESTIONS

A. Incorrect. Hematuria (blood in the urinE. and dysuria (painful urination) are not characteristic manifestations of nephrotic syndrome. Instead, they may indicate other kidney conditions or infections.

B. Incorrect. While clients with nephrotic syndrome may experience increased urine output (polyuriA. and nighttime urination (nocturiA. due to fluid imbalances, these are not the primary clinical manifestations.

C. Correct. Frothy, foamy urine output is a classic sign of nephrotic syndrome due to the presence of excessive protein (proteinuriA. in the urine. This foamy appearance is caused by the high levels of protein, mainly albumin, in the urine.

D. Incorrect. Suprapubic tenderness and urgency are not typical manifestations of nephrotic syndrome and may indicate other urinary tract or bladder issues.

A. Incorrect. Increased renal blood flow and fluid overload would lead to excessive urine output and reduced edema, which is not consistent with nephrotic syndrome.

B. Incorrect. Excessive sodium excretion and dehydration would lead to reduced fluid retention and edema, which is not consistent with nephrotic syndrome.

C. Correct. Nephrotic syndrome is characterized by glomerular damage, leading to increased permeability of the glomerular capillaries and loss of protein (mainly albumin) in the urine. This results in decreased oncotic pressure in the blood vessels, leading to edema in various parts of the body.

D. Incorrect. Elevated blood pressure and vascular leakage would lead to a different set of clinical manifestations, not characteristic of nephrotic syndrome.

A. Correct. Periorbital edema is a common manifestation of nephrotic syndrome, especially in the morning after fluid accumulation overnight. Elevated blood pressure and headache may accompany this edema, indicating fluid retention and hypertension, which are frequently associated with nephrotic syndrome.

B. Incorrect. Yellowish discoloration of the skin and sclera (jaundicE. is not a typical manifestation of nephrotic syndrome and is more indicative of liver dysfunction or bile flow obstruction.

C. Incorrect. Pain and tenderness over the lower back are not directly related to periorbital edema and may suggest a separate issue, such as musculoskeletal pain.

D. Incorrect. Shortness of breath and crackles in the lungs are not specific to nephrotic syndrome and may suggest other respiratory or cardiac issues.

A. Incorrect. Elevated blood pressure and fluid overload are more indicative of fluid retention and hypertension in nephrotic syndrome, not hypoalbuminemia.

B. Correct. Hypoalbuminemia, a common feature of nephrotic syndrome, results from the loss of albumin (a protein) in the urine. Low albumin levels can lead to muscle weakness and fatigue due to decreased oncotic pressure in the blood vessels, resulting in fluid shifting from the blood vessels to the interstitial spaces.

C. Incorrect. Hyperactivity and restlessness are not typical manifestations of hypoalbuminemia and nephrotic syndrome.

D. Incorrect. Pallor and cold extremities are not directly related to hypoalbuminemia and are not specific to nephrotic syndrome.

A. Incorrect. Elevated platelet count and clotting factors are not characteristic of nephrotic syndrome. Clients with nephrotic syndrome tend to have normal platelet counts.

B. Incorrect. Decreased blood viscosity and enhanced blood flow would not directly lead to an increased risk of thromboembolic events in nephrotic syndrome.

C. Incorrect. While impaired liver function may impact clotting factors, it is not a common manifestation of nephrotic

syndrome.

D. Correct. Nephrotic syndrome is associated with a loss of anticoagulant proteins, particularly antithrombin III, in the urine. This loss of anticoagulant proteins contributes to a state of hypercoagulability, increasing the risk of thromboembolic events, such as deep vein thrombosis and pulmonary embolism.

A. Incorrect. Abdominal distension and discomfort are not typical manifestations of a urinary tract infection, even in the presence of proteinuria.

B. Correct. Nephrotic syndrome often results in hypoalbuminemia due to significant protein loss in the urine. Hypoalbuminemia leads to decreased oncotic pressure in the blood vessels, causing fluid to leak into the peritoneal cavity and resulting in abdominal distension and discomfort, known as ascites.

C. Incorrect. Hyperkalemia may occur in chronic kidney disease, including nephrotic syndrome, but it is not directly related to abdominal distension and discomfort.

D. Incorrect. Renal vein thrombosis is a complication of nephrotic syndrome but is not typically associated with acute abdominal distension and discomfort.

A. Incorrect. While increased cholesterol synthesis in the liver can contribute to hyperlipidemia, it is not the primary reason for elevated lipid levels in nephrotic syndrome.

B. Incorrect. Impaired fat absorption in the small intestine is not a significant factor contributing to hyperlipidemia in nephrotic syndrome.

C. Correct. Nephrotic syndrome results in increased protein loss, including proteins involved in lipid transport and metabolism. Reduced clearance of lipids by the kidneys leads to elevated lipid levels in the bloodstream.

D. Incorrect. Elevated blood glucose levels and insulin resistance are not directly related to hyperlipidemia in nephrotic syndrome.

QUESTIONS

A. Incorrect. While a renal biopsy may provide information about kidney function and glomerular filtration rate, its primary purpose in diagnosing nephrotic syndrome is to identify the specific histopathological changes in the kidney, which can help confirm the diagnosis and guide treatment decisions.

B. Incorrect. The response to diuretic therapy can be monitored through other means, such as assessing urine output and fluid balance. A renal biopsy is not performed primarily to evaluate the response to diuretics.

C. Incorrect. Renal biopsy is not typically used to evaluate the extent of renal inflammation and infection. Other imaging or laboratory tests are more suitable for assessing renal inflammation and infection.

D. Correct. A renal biopsy is the definitive diagnostic procedure for nephrotic syndrome. It allows the pathologist to examine a small tissue sample from the kidney and identify the specific histopathological changes, such as glomerular changes, that confirm the diagnosis.