1.
What is the primary disadvantage of using peritoneal dialysis for long-term management of chronic renal failure?
Correct Answer
C. It is a time consuming method of treatment.
Explanation
The disadvantages of peritoneal dialysis in the long-term management of chronic renal failure is that requires large blocks of time.Options A and D: The risk of hemorrhage or hepatitis is not high with PD.Option B: PD is effective in maintaining a client’s fluid and electrolyte balance.
2.
The dialysis solution is warmed before use in peritoneal dialysis primarily to:
Correct Answer
A. Encourage the removal of serum urea.
Explanation
The main reason for warming the peritoneal dialysis solution is that the warm solution helps dilate peritoneal vessels. which increases urea clearance.Options B and D: The warmed solution does not force potassium into the cells or promote abdominal muscle relaxation.Option C: Warmed dialyzing solution also contributes to client comfort by preventing chilly sensations. but this is a secondary reason for warming the solution.
3.
During the client’s dialysis. the nurse observes that the solution draining from the abdomen is consistently blood tinged. The client has a permanent peritoneal catheter in place. Which interpretation of this observation would be correct?
Correct Answer
B. Bleeding indicates abdominal blood vessel damage
Explanation
Because the client has a permanent catheter in place. blood tinged drainage should not occur. Persistent blood tinged drainage could indicate damage to the abdominal vessels. and the physician should be notified.Option C: The bleeding is originating in the peritoneal cavity. not the kidneys.Option D: Too rapid infusion of the dialysate can cause pain.
4.
Which of the following nursing interventions should be included in the client’s care plan during dialysis therapy?
Correct Answer
B. Monitor the client’s blood pressure
Explanation
Because hypotension is a complication of peritoneal dialysis. the nurse records intake. and output. monitors VS. and observes the client’s behavior.Option A: The nurse also encourages visiting and other diversional activities.Options C and D: A client on PD does not need to be placed in bed with padded side rails or kept NPO.
5.
Aluminum hydroxide gel (Amphojel) is prescribed for the client with chronic renal failure to take at home. What is the purpose of giving this drug to a client with chronic renal failure?
Correct Answer
C. To bind pHospHorus in the intestine
Explanation
A client in renal failure develops hyperphosphatemia that causes a corresponding excretion of the body’s calcium stores. leading to renal osteodystrophy. To decrease this loss. aluminum hydroxide gel is prescribed to bind phosphates in the intestine and facilitate their excretion.Option A: Gastric hyperacidity is not necessarily a problem associated with chronic renal failure.Options B and D: Antacids will not prevent Curling’s stress ulcers and do not affect metabolic acidosis.
6.
The nurse teaches the client with chronic renal failure when to take the aluminum hydroxide gel. Which of the following statements would indicate that the client understands the teaching?
Correct Answer
D. “I’ll take it with meals and bedtime snacks.”
Explanation
Aluminum hydroxide gel is administered to bind the phosphates in ingested foods and must be given with or immediately after meals and snacks.Option A: There is no need for the client to take it on a 24-hour schedule.Options B and C: It is not administered to treat hyperacidity in clients with CRF and therefore is not prescribed between meals.
7.
The client with chronic renal failure tells the nurse he takes magnesium hydroxide (milk of magnesia) at home for constipation. The nurse suggests that the client switch to psyllium hydrophilic mucilloid (Metamucil) because:
Correct Answer
A. MOM can cause magnesium toxicity
Explanation
Magnesium is normally excreted by the kidneys. When the kidneys fail. magnesium can accumulate and cause severe neurologic problems.Option B: MOM is harsher than Metamucil. but magnesium toxicity is a more serious problem.Option C: A client may find both MOM and Metamucil unpalatable.Option D: MOM is not high in sodium.
8.
In planning teaching strategies for the client with chronic renal failure. the nurse must keep in mind the neurologic impact of uremia. Which teaching strategy would be most appropriate?
Correct Answer
B. Validating frequently the client’s understanding of the material.
Explanation
Uremia can cause decreased alertness. so the nurse needs to validate the client’s comprehension frequently.Option A: Because the client’s ability to concentrate is limited. short lesions are most effective.Option C: If family members are present at the sessions. they can reinforce the material.Option D: Written materials that the client can review are superior to videotapes. because the clients may not be able to maintain alertness during the viewing of the videotape.
9.
The nurse helps the client with chronic renal failure develop a home diet plan with the goal of helping the client maintain adequate nutritional intake. Which of the following diets would be most appropriate for a client with chronic renal failure?
Correct Answer
C. Low protein. low sodium. low potassium
Explanation
Dietary management for clients with chronic renal failure is usually designed to restrict protein. sodium. and potassium intake. Protein intake is reduced because the kidney can no longer excrete the byproducts of protein metabolism. Reducing sodium in the diet helps to control high blood pressure. It also keeps one from being thirsty and prevents the body from holding onto extra fluid. Too much potassium can build up when the kidneys no longer function well. It can cause an irregular heartbeat or a heart attack.
10.
A client with chronic renal failure has asked to be evaluated for a home continuous ambulatory peritoneal dialysis (CAPD) program. The nurse should explain that the major advantage of this approach is that it:
Correct Answer
B. Allows the client to be more independent
Explanation
The major benefit of CAPD is that it frees the client from daily dependence on dialysis centers. home health care personnel. and machines for life-sustaining treatment. The independence is a valuable outcome for some people.Option A: CAPD is costly and must be done daily.Option D: Side effects and complications are similar to those of standard peritoneal dialysis.