Nokea
The patient has just returned from having an arteriovenous fistula placed. The patient asks, “When will they be able to use this and take this other catheter out?” The nurse should reply,
- A. “It can be used immediately, so the catheter can come out anytime.”
- B. “It will take 2 to 4 weeks to heal before it can be used.”
- C. “The fistula will be usable in about 4 to 6 weeks.”
- D. “The fistula was made using graft material, so it depends on the manufacturer.”
Correct Answer: C
Rationale: The correct answer is C: “The fistula will be usable in about 4 to 6 weeks.” This is because arteriovenous fistulas typically require a maturation period of 4 to 6 weeks before they can be used for dialysis. During this time, the fistula will develop into a strong, durable access point for hemodialysis.
Choice A is incorrect because the fistula needs time to mature before it can be used, and immediate use may damage it. Choice B is incorrect as it underestimates the maturation period required. Choice D is incorrect as the maturation time does not depend on the manufacturer but on the patient's physiology and healing process.
You may also like to solve these questions
The most common reasons for initiating dialysis in acute kidney injury include which of the following? (Select all that apply.)
- A. Acidosis
- B. Hypokalemia
- C. Volume overload
- D. Hyperkalemia
Correct Answer: A
Rationale: Explanation:
A: Acidosis is a common reason to initiate dialysis in acute kidney injury due to impaired acid-base balance.
B: Hypokalemia is not a common reason for initiating dialysis in acute kidney injury.
C: Volume overload may require dialysis but is not as common as acidosis.
D: Hyperkalemia is a valid reason for dialysis but not as common as acidosis in acute kidney injury.
The most significant clinical finding of acute adrenal crisis associated with fluid and electrolyte imbalance is
- A. fluid volume excess.
- B. hyperglycemia.
- C. hyperkalemia
- D. hypernatremia
Correct Answer: C
Rationale: Step-by-step rationale for the correct answer (C: hyperkalemia):
1. Adrenal crisis leads to adrenal insufficiency, causing decreased cortisol levels.
2. Cortisol plays a crucial role in regulating potassium levels.
3. With decreased cortisol, potassium levels can rise, leading to hyperkalemia.
4. Hyperkalemia can result in life-threatening cardiac arrhythmias.
Summary:
A: Fluid volume excess is not typical in adrenal crisis.
B: Hyperglycemia can be present but is not the most significant finding.
D: Hypernatremia is not a typical feature of adrenal crisis.
Slow continuous ultrafiltration is also known as isolated ultrafiltration and is used to
- A. remove plasma water in cases of volume overload.
- B. remove fluids and solutes through the process of convection.
- C. remove plasma water and solutes by adding dialysate.
- D. combine ultrafiltration, convection, and dialysis.
Correct Answer: A
Rationale: Rationale:
Slow continuous ultrafiltration is a method used to remove excess plasma water in cases of volume overload, making choice A the correct answer. This process does not involve adding dialysate (choice C) or combining ultrafiltration, convection, and dialysis (choice D). While ultrafiltration does involve the removal of fluids and solutes, it is primarily achieved through ultrafiltration rather than convection (choice B).
The nurse is caring for a patient receiving peritoneal dialysis. The patient suddenly complains of abdominal pain and chills. The patient’s temperature is elevated. The nurse should
- A. assess peritoneal dialysate return.
- B. check the patient’s blood sugar.
- C. evaluate the patient’s neurological status.
- D. inform the provider of probable visceral perforation.
Correct Answer: D
Rationale: The correct answer is D: inform the provider of probable visceral perforation. This is the most urgent action as sudden abdominal pain, chills, and elevated temperature in a patient receiving peritoneal dialysis could indicate a serious complication like visceral perforation, which requires immediate medical attention to prevent further complications. Assessing peritoneal dialysate return (A) may provide some information but does not address the urgent need to address a potential visceral perforation. Checking the patient's blood sugar (B) and evaluating the patient's neurological status (C) are not priorities in this situation and do not address the potential life-threatening complication of visceral perforation.
The nurse is caring for an elderly patient who was admitted with renal insufficiency. An expected laboratory finding for this patient may be
- A. an increased glomerular filtration rate (GFR).
- B. a normal serum creatinine level.
- C. increased ability to excrete drugs.
- D. hypokalemia.
Correct Answer: C
Rationale: Correct Answer: C - Increased ability to excrete drugs.
Rationale:
1. Renal insufficiency impairs kidney function, leading to decreased excretion of drugs.
2. In elderly patients with renal insufficiency, there may be compensatory mechanisms to enhance drug excretion.
3. This increased ability to excrete drugs helps prevent drug accumulation and potential toxicity.
Summary:
A: Increased GFR is not expected in renal insufficiency; it typically decreases.
B: Serum creatinine level would likely be elevated in renal insufficiency, not normal.
D: Hypokalemia is not a typical lab finding in renal insufficiency; hyperkalemia is more common.