3 hours ago • Nurse must assess and evaluate patient for possible cause of fever. • Notify the treating nephrologist and if ordered by the physician, obtain blood culture(s) per procedure and send to the laboratory. • Provide for comfort measures, and administer antipyretics as ordered. • Administer patient for permanent access evaluation. Prevention: >> Go To The Portal
The nurse notes in the first few exchanges during peritoneal dialysis of a client that the effluent is tinged pink. The nurse's most appropriate action is to a. continue the dialysis. b. notify the physician.
A client newly diagnosed with renal failure has just been started on peritoneal dialysis. During the infusion of the dialysate, the client complains of abdominal pain. Which action by the nurse is appropriate? 1. Stop the dialysis. 2. Slow the infusion 3. Decrease the amount to be infused. 4. Explain that the pain will subside after the
The priority action by the nurse is to notify the physician; the nurse should not independently slow the dialysis rate or encourage the client to drink fluids as fluids may be restricted. Oxygen will not help the situation. What is the normal lab value for Urine RBCs? <4 RBC/HPF
The client receiving dialysis is complaining of being dizzy and light-headed. Which action should the nurse implement first? 1. Place the client in the Trendelenburg position. 2. Turn off the dialysis machine immediately.
Assess for and report redness, local warmth, edema, drainage, or tenderness at exit site. Culture any exudate, and report results to health care provider. These are signs of infection at the exit site. Maintain sterile technique when adding medications to dialysate.
Monitor serum electrolytes, blood urea nitrogen, creatinine, and hemoglobin and hematocrit levels before and after dialysis. Monitor fluid status. Monitor coagulation studies because heparin is used to prevent clotting during dialysis.
RisksLow blood pressure (hypotension). A drop in blood pressure is a common side effect of hemodialysis. ... Muscle cramps. Although the cause is not clear, muscle cramps during hemodialysis are common. ... Itching. ... Sleep problems. ... Anemia. ... Bone diseases. ... High blood pressure (hypertension). ... Fluid overload.More items...•
If your kidneys are not working well, toxins (waste products) build up in your blood and this can make you feel tired and weak. You may feel more tired as your CKD progresses. Kidney damage can also lead to a shortage of red blood cells, causing you to be anaemic.
Non-pharmacological interventions targeting nutrition, sleep hygiene, stress management, and treatment of depression may potentially decrease fatigue. Some small studies indicate that acupressure may help to improve fatigue, depression and sleep quality in dialysis patients.
The most common side effects of hemodialysis include low blood pressure, access site infection, muscle cramps, itchy skin, and blood clots. The most common side effects of peritoneal dialysis include peritonitis, hernia, blood sugar changes, potassium imbalances, and weight gain.
Symptoms include hypotension, chest pain, dyspnea, and (my favorite) a “sense of impending doom.” An outbreak of Type A reactions was previously associated with ethlyene oxide, once used in the dialyzer sterilization procedure, but can presumably be due to other leachable compounds within dialysis cartridges.
To see how well kidney dialysis is working, your care team can check your weight and blood pressure before and after each session. Regular blood tests, such as those measuring blood urea nitrogen and creatinine levels, and other specialized evaluations also help assess the effectiveness of treatment.
Patients with end-stage renal disease (ESRD) on long-term dialysis therapy have very high mortality due to predominantly cardiovascular causes1 (Figure 1). Sudden cardiac death (SCD) is the single most common form of death in dialysis patients, accounting for 20% to 30% of all deaths in this cohort.
Fatigue, where you feel tired and exhausted all the time, is a common side effect in people who use either form of dialysis on a long-term basis. Fatigue is thought to be caused by a combination of the: loss of normal kidney function. effects dialysis can have on the body.
So far, clinical trials have focused on physical activity and available treatments for known correlates of fatigue, such as anemia and depression.Physical Activity. ... Erythropoiesis-Stimulating Agents. ... Alkali Supplementation. ... Vitamin D Supplementation. ... Selective Serotonin Reuptake Inhibitors.
If a person on dialysis also has diabetes, spreading out carbohydrates throughout the day will help control blood sugar and contribute to feeling energized. The key for optimal energy is having a consistent amount of carbohydrates at each meal. The timing of meals is highly related to a person's energy levels.
Symptoms of renal calculi include excruciating flank pain and renal colic. When a stone is lodged in the ureter, it is common to have pain radiate down to the genitalia. The pain results when the stone prevents urine from draining. The patient also may have costovertebral tenderness.
c. Bacteria probably ascended the catheter, causing the infection.
Of the tests listed a normal 24-hour creatinine clearance of 100 mL/min is the most accurate test for renal function. A value less than 100 mL/min indicates kidney disease. A. B. Hematocrit and uric acid levels are not used to diagnose kidney disease. D. Blood urea nitrogen test is also used to detect kidney disease however the value is within normal limits.
For a nephrostomy tube, the nurse should ensure that it is draining adequately and is not kinked or clamped. B. Fluids do not need to be limited. C. The collection bag does not need to be taped to the abdomen. D. The tube is not to be removed and cleaned.
The urine from an ileal conduit contains mucus because it comes through the ileum, which normally secretes mucus. A. B. C. There is no need to notify the physician, send a specimen for culture, or ask the patient about a history of UTIs.
Because this is a hereditary disorder, genetic counseling is appropriate. There is no treatment to stop the progression of polycystic kidney disease. Polycystic kidney disease is characterized by formation of multiple cysts in the kidney that can eventually replace normal kidney structures. B.
Suprabladder is not a type of kidney injury. A 19-year-old patient reports flank pain and scanty urination. The nurse notices periorbital edema, and the urinalysis reveals white blood cells, red blood cells, albumin, and casts. What question would be most important for the nurse to include in data collection? a.
During routine hemodialysis, the 68-year-old patient complains of nausea and dizziness. Which action should the nurse take first?
A 42-year-old patient admitted with acute kidney injury due to dehydration has oliguria, anemia, and hyperkalemia. Which prescribed actions should the nurse take first?
c. More protein is allowed because urea and creatinine are removed by dialysis.
Angiotensin-converting enzyme (ACE) inhibitors are frequently used in patients with CKD because they delay the progression of the CKD, but they cause potassium retention. Therefore careful monitoring of potassium levels is needed in patients who are at risk for hyperkalemia. The other laboratory values would also be monitored in patients with CKD but would not affect whether the captopril was given or not.
Phosphate binders are taken with meals to help control serum phosphate and calcium levels. Commercial salt substitutes are high in potassium and should be avoided. Fluid intake is limited in patients requiring dialysis. Dairy products are high in phosphate and usually are limited.
When a patient at risk for chronic kidney disease (CKD) receives a potentially nephrotoxic medication, it is important to monitor renal function with BUN and creatinine levels. The other laboratory values would not be useful in assessing for the adverse effects of the gentamicin.
The increasing QRS interval is suggestive of hyperkalemia, so the nurse should check the most recent potassium and then notify the patient's health care provider. The BUN and creatinine will be elevated in a patient with AKI, but they would not directly affect the electrocardiogram (ECG). Documentation of the QRS interval is also appropriate, but interventions to decrease the potassium level are needed to prevent life-threatening dysrhythmias.
A ~ The principal feature of acute renal failure is oliguria; hypertension is a nonspecific clinical manifestation. Hematuria and pallor, proteinuria and muscle cramps, and bacteriuria and facial edema are not principal features of acute renal failure.
C ~ Chronic renal failure leads to water and sodium retention, which contributes to edema and vascular congestion. Hyperkalemia, metabolic acidosis, and retention of blood urea nitrogen are complications of chronic renal failure.
D ~ The most common cause of acute renal failure in children is dehydration or other causes of poor perfusion that may respond to restoration of fluid volume. Pyelonephritis and tubular destruction are not common causes of acute renal failure. Obstructive uropathy may cause acute renal failure, but it is not the most common cause.
Signs of hyperkalemia include electrocardiograph anomalies such as prolonged QRS complex, depressed ST segments, peaked T waves, bradycardia, or heart block. Dyspnea, seizure, and oliguria are not manifestations of hyperkalemia.
A ~ The most common overall manifestation of ARF is alteration in the expected urine output. Usually this is oliguria or anuria, although polyuric ARF accounts for 30% of cases.
D ~ Hyperkalemia is probably the most dangerous imbalance because of its contribution to cardiac dysrhythmias and arrest. Cation exchange resins such as sodium polystyrene sulfonate (Kayexalate) may be administered orally or rectally to facilitate excretion of potassium from the gastrointestinal (GI) tract.
A client with ARF is allowed a specific amount of fluid by mouth during 24 hours in order to
The nurse should check for hypoxemia, a hallmark of ARDS. The health care provider should be notified after further assessment of the patient. Giving the scheduled antibiotic and the PRN acetaminophen will also be done, but they are not the highest priority for a patient who may be developing ARDS.
a. Position the patient on the left side.
While caring for a patient who has been admitted with a pulmonary embolism, the nurse notes a change in the patient's oxygen saturation (SpO2) from 94% to 88%. Which action should the nurse take?
The other drugs are appropriate for the patient with ARDS. A patient develops increasing dyspnea and hypoxemia 2 days after heart surgery. To determine whether the patient has acute respiratory distress syndrome (ARDS) or pulmonary edema caused by heart failure, the nurse will plan to assist with.
A patient with respiratory failure has a respiratory rate of 6 breaths/min and an oxygen saturation (SpO2) of 88%. The patient is increasingly lethargic. Which intervention will the nurse anticipate?
The patient's respirations have dropped to 10 breaths/minute. ANS: D. A drop in respiratory rate in a patient with respiratory distress suggests the onset of fatigue and a high risk for respiratory arrest. Therefore immediate action such as positive-pressure ventilation is needed.
The patient should be positioned with the "good" lung in the dependent position to improve the match between ventilation and perfusion. The obese patient's abdomen will limit respiratory excursion when sitting in the high-Fowler's or tripod positions.