Nokea
The client diagnosed with chronic renal failure (CRF) is prescribed hemodialysis on Monday, Wednesday, and Friday. Which interventions should the nurse implement? Select all that apply.
- A. Weigh the client before and after each treatment.
- B. Discuss the recommended fluid restriction.
- C. Provide potato chips or pretzels as a snack.
- D. Monitor the hemodialysis access site continuously.
- E. Keep up a lively conversation during the treatments.
Correct Answer: A,B,D
Rationale: Weighing pre/post-dialysis assesses fluid removal, fluid restriction education prevents overload, and monitoring the access site prevents complications. Salty snacks increase thirst, and conversation is not a priority intervention.
You may also like to solve these questions
When the nurse examines the voided urine specimen, which finding is most supportive of the diagnosis of urolithiasis?
- A. Cloudy pale urine
- B. Blood-tinged urine
- C. Light yellow urine
- D. Strong-smelling urine
Correct Answer: B
Rationale: Blood-tinged urine (hematuria) is a hallmark of urolithiasis due to irritation or injury from kidney stones.
Postoperatively, which assessment finding is most suggestive that the client is hemorrhaging?
- A. Acute flank pain
- B. Abdominal distention
- C. Flushed, warm skin
- D. Nausea and vomiting
Correct Answer: B
Rationale: Abdominal distention may indicate internal bleeding, a critical sign of hemorrhage post-nephrectomy.
The nurse is developing a plan of care for a client diagnosed with ARF. Which statement is an appropriate outcome for the client?
- A. Monitor intake and output every shift.
- B. Decrease of pain by three (3) levels on a 1-to-10 scale.
- C. Electrolytes are within normal limits.
- D. Administer enemas to decrease hyperkalemia.
Correct Answer: C
Rationale: An appropriate outcome for ARF is achieving normal electrolyte levels, as imbalances like hyperkalemia are common. Monitoring intake/output and administering enemas are interventions, not outcomes, and pain reduction is less specific to ARF.
The nurse caring for a client diagnosed with CKD writes a client problem of 'noncompliance with dietary restrictions.' Which intervention should be included in the plan of care?
- A. Teach the client the proper diet to eat while undergoing dialysis.
- B. Refer the client and significant other to the dietitian.
- C. Explain the importance of eating the proper foods.
- D. Determine the reason for the client not adhering to the diet.
Correct Answer: D
Rationale: Determining the reason for noncompliance (e.g., lack of understanding, financial barriers) is the first step to tailor interventions effectively. Teaching, referrals, or explaining importance are secondary until the root cause is identified.
When the client with an ileal conduit expresses concern about odor, which recommendation by the nurse is most effective?
- A. Place an aspirin tablet in the pouch.
- B. Use a deodorizing pouch spray.
- C. Change the pouch daily.
- D. Avoid acidic foods.
Correct Answer: B
Rationale: Using a deodorizing pouch spray effectively controls odor, addressing the client's concern.