Question

A nurse is providing discharge teaching to a client who will be performing continuous ambulatory peritoneal dialysis (CAPD) at home. Which of the following statements from the client indicates an understanding of this type of dialysis management? (Select all that apply)

Answer 1

Correct Answers:

"l must wash my hands every time before I connect the tubing to the catheter in my stomach."
will weigh myself daily and keep track of my weight in my dialysis record."
"l will check my blood pressure and follow the instructions related to changes I might need to do based on the results."

Rationale :

🧼Hand hygiene is a critical step in preventing peritonitis, a major complication of CAPD, and must be practiced before each exchange.

⚖️Daily weight monitoring helps assess fluid retention or loss, indicating the effectiveness of dialysis or potential fluid imbalance.

📉Monitoring blood pressure is essential because CAPD can influence fluid and electrolyte balance, which directly impacts hemodynamic stability.

🛌The statement about lying down during dwelling and instilling fluid only once daily is incorrect because CAPD requires multiple exchanges a day, and patients can remain active during dwell time.

📌Core message

Effective CAPD management involves strict hand hygiene, daily weight and BP monitoring, and understanding that multiple exchanges per day are required.

Answer 2

Correct Answers:

Pruritus
Slurred speech
Bone pain

Rationale :

🧴Pruritus is common in ESRD due to uremic toxins accumulating in the skin.

🗣️Slurred speech may occur from neurological effects of uremia, especially in advanced kidney failure.

🦴Bone pain results from calcium-phosphorus imbalances and renal osteodystrophy, a frequent complication of ESRD.

📉Hypotension and bradypnea are less common and usually associated with over-treatment or other acute issues, not baseline ESRD.

📌Core message

Clients with end-stage renal disease commonly experience neurologic symptoms, pruritus, and bone pain due to toxin retention and mineral imbalance.

Answer 3

Correct Answers:

Hyperkalemia

Rationale :

⚡Hyperkalemia is expected in prerenal AKI because decreased renal perfusion leads to impaired potassium excretion.

🧂Hypernatremia may occur with dehydration but is less typical than potassium imbalance.

💀Hypercalcemia and hypophosphatemia are not usually associated with AKI and may point to different pathologies.

🧪Electrolyte imbalance in AKI often includes elevated potassium and BUN/creatinine, which can affect cardiac and neuromuscular function.

📌Core message

Hyperkalemia is a common and dangerous electrolyte imbalance in prerenal AKI, caused by reduced renal clearance.

Answer 4

Correct Answers:

Serum creatinine I .8 mg/dL

Rationale :

🧪Serum creatinine is a sensitive indicator of kidney function, and a level of 1.8 mg/dL in an older adult female indicates impaired filtration.

🧮BUN of 200 mg/dL is extremely elevated and could suggest severe uremia, but is less specific than creatinine alone.

💧Serum osmolality and magnesium are not as reliable for detecting AKI as creatinine levels.

👵Older adults are more susceptible to renal damage, and even small elevations in creatinine require close monitoring.

📌Core message

An elevated creatinine in an older adult following MI may signal developing AKI, requiring prompt attention.

Answer 5

Correct Answers:

Fever
Gastrointestinal upset
Flank pain

Rationale :

🌡️Fever can indicate infection or inflammation associated with renal calculi.

🤢GI upset, including nausea and vomiting, is common due to pain and sympathetic nervous system stimulation.

🔪Flank pain is the classic hallmark of renal calculi, resulting from ureteral spasm or obstruction.

🚽Urinary urgency and incontinence are more typical in bladder infections, not renal stones.

📌Core message

Renal calculi often present with flank pain, fever, and GI symptoms due to inflammation and obstruction.

Answer 6

Correct Answers:

Coldness and numbness distal to the fistula site

Rationale :

🧊Coldness and numbness suggest poor perfusion distal to the AV fistula, a sign of venous insufficiency or steal syndrome.

🚫Pain proximal to the site and rash are nonspecific and not hallmark signs of vascular compromise.

🦠Foul-smelling drainage indicates infection, not venous insufficiency specifically.

🩸Monitoring distal circulation is critical to prevent ischemic complications in AV fistulas.

📌Core message

In clients with an AV fistula, signs like coldness and numbness distal to the site point to venous insufficiency or ischemia.

Answer 7

Correct Answers:

"The kidneys continue to enlarge due to the cysts growing, which increases the girth of your abdomen."

Rationale :

🏥Polycystic kidney disease (PKD) leads to progressive enlargement of the kidneys due to growing cysts, increasing abdominal girth.

📈This abdominal swelling is not from fluid retention, but organ enlargement.

🔄Blockage from stones may cause pain but not generalized abdominal distention.

💬This explanation helps educate and reassure the patient by accurately describing PKD progression.

📌Core message

In PKD, increasing abdominal girth is due to cystic kidney enlargement, not fluid accumulation.

Answer 8

Correct Answers:

Serum creatinine 6 mg/dL

Rationale :

🧪Serum creatinine is a direct indicator of renal function, and a value of 6 mg/dL is consistent with acute kidney injury.

🧮The other lab values are all within normal or near-normal limits, making them less significant in this context.

🧠High creatinine reflects poor glomerular filtration and may require dialysis or immediate intervention.

🧾Accurate identification of such lab findings helps in early detection and treatment of AKI.

📌Core message

A serum creatinine of 6 mg/dL clearly indicates acute kidney injury and requires immediate clinical attention.

Answer 9

Correct Answers:

Purulent dialysate outflow

Rationale :

🦠Purulent outflow during peritoneal dialysis is a sign of peritonitis, a serious and potentially life-threatening infection.

🚨It warrants immediate provider notification to initiate antibiotics and prevent complications.

🩸Bloody or uncomfortable inflow may be expected early in therapy but do not signify infection.

💧Dialysate leakage is common in initial sessions and often resolves without emergency action.

📌Core message

In peritoneal dialysis, purulent outflow is a critical sign of infection and requires immediate medical response.

Answer 10

Correct Answers:

Dehydration

Rationale :

🚱Dehydration concentrates urinary solutes, increasing the risk of stone formation, especially calcium or uric acid stones.

⚠️It is one of the most common and modifiable risk factors for urolithiasis.

🍗Protein in urine is more related to kidney damage, not directly to stone formation.

📏Obesity and iron deficiency do not have a direct causative link with stone development.

📌Core message

Dehydration is a key risk factor for renal calculi, highlighting the importance of adequate fluid intake.

1 :
A nurse is providing discharge teaching to a client who will be performing continuous ambulatory peritoneal dialysis (CAPD) at home. Which of the following statements from the client indicates an understanding of this type of dialysis management? (Select all that apply)

2 :
A nurse is caring for a client who has end-stage renal disease (ESRD). Which of the following are expected findings? (Select all that apply).

3 :
A nurse is reviewing the laboratory test results from a client who has prerenal acute kidney injury (AKI). Which of the following electrolyte imbalances should the nurse expect?

4 :
A nurse is monitoring an older adult female client who had a myocardial infarction (MI) for the development of acute kidney injury (AKI). Which of the following findings should the nurse identify as indicating an increased risk of AKI?

5 :
A nurse is caring for a client admitted with renal calculus. Which of the following assessment findings should the nurse associate with renal calculi? (Select all that apply)

6 :
A nurse is providing discharge teaching to a client who has a new arteriovenous fistula in the right forearm. Which of the following manifestations should the nurse include in the teaching as possible indications of venous insufficiency?

7 :
A nurse is caring for a client who has polycystic kidney disease (PKD). The client is admited to the hospital for renal calculi and reports that their abdomen has been getting bigger. Which of the following statements by the nurse is the best explanation for the increase in abdominal girth?

8 :
A nurse is reviewing laboratory findings for four clients. Which of the following clients has manifestations of acute kidney injury?

9 :
A nurse is caring for a client who is undergoing initial peritoneal dialysis. Which of the following should the nurse report immediately to the provider?

10 :
A nurse is teaching a client who has urolithiasis (renal calculi). The nurse should explain that which of the following conditions can increase the risk for renal calculi?

1 : A nurse is providing discharge teaching to a client who will be performing continuous ambulatory peritoneal dialysis (CAPD) at home. Which of the following statements from the client indicates an understanding of this type of dialysis management? (Select all that apply)

2 : A nurse is caring for a client who has end-stage renal disease (ESRD). Which of the following are expected findings? (Select all that apply).

3 : A nurse is reviewing the laboratory test results from a client who has prerenal acute kidney injury (AKI). Which of the following electrolyte imbalances should the nurse expect?

4 : A nurse is monitoring an older adult female client who had a myocardial infarction (MI) for the development of acute kidney injury (AKI). Which of the following findings should the nurse identify as indicating an increased risk of AKI?

5 : A nurse is caring for a client admitted with renal calculus. Which of the following assessment findings should the nurse associate with renal calculi? (Select all that apply)

6 : A nurse is providing discharge teaching to a client who has a new arteriovenous fistula in the right forearm. Which of the following manifestations should the nurse include in the teaching as possible indications of venous insufficiency?

7 : A nurse is caring for a client who has polycystic kidney disease (PKD). The client is admited to the hospital for renal calculi and reports that their abdomen has been getting bigger. Which of the following statements by the nurse is the best explanation for the increase in abdominal girth?

8 : A nurse is reviewing laboratory findings for four clients. Which of the following clients has manifestations of acute kidney injury?

9 : A nurse is caring for a client who is undergoing initial peritoneal dialysis. Which of the following should the nurse report immediately to the provider?

10 : A nurse is teaching a client who has urolithiasis (renal calculi). The nurse should explain that which of the following conditions can increase the risk for renal calculi?

1 :
A nurse is providing discharge teaching to a client who will be performing continuous ambulatory peritoneal dialysis (CAPD) at home. Which of the following statements from the client indicates an understanding of this type of dialysis management? (Select all that apply)

2 :
A nurse is caring for a client who has end-stage renal disease (ESRD). Which of the following are expected findings? (Select all that apply).

3 :
A nurse is reviewing the laboratory test results from a client who has prerenal acute kidney injury (AKI). Which of the following electrolyte imbalances should the nurse expect?

4 :
A nurse is monitoring an older adult female client who had a myocardial infarction (MI) for the development of acute kidney injury (AKI). Which of the following findings should the nurse identify as indicating an increased risk of AKI?

5 :
A nurse is caring for a client admitted with renal calculus. Which of the following assessment findings should the nurse associate with renal calculi? (Select all that apply)

6 :
A nurse is providing discharge teaching to a client who has a new arteriovenous fistula in the right forearm. Which of the following manifestations should the nurse include in the teaching as possible indications of venous insufficiency?

7 :
A nurse is caring for a client who has polycystic kidney disease (PKD). The client is admited to the hospital for renal calculi and reports that their abdomen has been getting bigger. Which of the following statements by the nurse is the best explanation for the increase in abdominal girth?

8 :
A nurse is reviewing laboratory findings for four clients. Which of the following clients has manifestations of acute kidney injury?

9 :
A nurse is caring for a client who is undergoing initial peritoneal dialysis. Which of the following should the nurse report immediately to the provider?

10 :
A nurse is teaching a client who has urolithiasis (renal calculi). The nurse should explain that which of the following conditions can increase the risk for renal calculi?