Treatment Options
This treatment is considered the standard approach to treat ESRD.
What is hemodialysis?
True or False:
ESRD mortality rate has decreased in the United States over the last 10 years.
What is false?
The nurse should be mostly concerned and should monitor the patient for this hemodialysis complication.
What is hypotension?
This electrolyte affects the heart and should be the nurse's highest priority when assessing patients with ESRD.
What is Potassium?
The renal diet should be low in phosphorus, sodium, and this electrolyte.
What is potassium?
This treatment mainly uses medications to treat symptoms of ESRD.
What is conservative medical management?
The nurse is monitoring a client during a hemodialysis treatment when the client complains of chest pain and difficulty breathing. The nurse notes that the client’s pulse rate is 110 beats per minute and the blood pressure is 98/60 mm Hg. Cyanosis is noted around the lips and the pulse oximetry reading is 88%. The nurse suspects an air embolism. The nurse should do these.
1. Stops the hemodialysis, and does not reinfuse blood
2. Turns the client on the left side, with the head down (Trendelenburg’s position).
3. Stays with the client and asks another person to notify the PHCP and the Rapid Response Team
4. Administers oxygen
5. Assesses vital signs and pulse oximetry
6. Documents the event, actions taken, and the client’s response
The nurse reviews serum labs for the ESRD patient and is mostly concerned with which of the following results?
Ca 8.7, K+ 6.4, pH 7.34, BUN 34
What is K+ 6.4?
The following are signs and symptoms of ESRD except:
Nausea and vomiting, Hypotension, Decreased urinary output, Edema
What is Hypotension?
The nurse should educate the ESRD patient regarding this.
What is fluid restriction?
Hemodialysis requires the patient to go for treatment this many times per week.
What is three times (3x) a week?
True or False
Hemorrhage, hepatitis, hypotension, sepsis, and shock are complications of hemodialysis.
What is true?
ESRD patients should avoid this type of over-the-counter pain reliever.
What are NSAIDs / Ibuprofen?
True or False:
The nurse should not worry about weight gain or hypertension in the ESRD patient.
What is false?
True or False:
Vitamin D and Calcium supplements should be added to the ESRD patient's diet plan.
What is true?
True or False:
Conservative Medical Management does not require a commitment for several weekly appointments.
What is true?
When faced with uncomfortable conversations about end of life care, the nurse should NOT ________.
What is avoid or change the topic?
Assuming a patient's kidney function and overall health is consistently declining, when should a nurse intervene and suggest the patient switch from conservative medical management to hemodialysis?
What is NEVER? It is not the nurse's place to make that decision.
A decrease in this filtration rate would also alert the nurse that the patient is most likely diagnosed with chronic kidney disease.
What is GFR (glomerular filtration rate)?
A nurse walks into the ESRD patient's room and notices the patient eating a banana and saying "I love bananas, it is my favorite fruit." What action(s) should the nurse take?
What is educate the patient on potassium consumption?
May take the banana away after educating the patient.
True or False
Anemia in ESRD results from the decreased secretion of erythropoietin by damaged nephrons, resulting in decreased production of red blood cells.
What is true?
Contraindications of peritoneal dialysis are these.
What are peritonitis, recent abdominal surgery, and abdominal adhesions?
Interventions post-op kidney transplantation are these.
What are monitor vital signs, signs of complications such as rejection, thrombosis, renal artery stenosis, or wound problems, monitor urine output, and daily weight.
Clinical manifestations of kidney transplant includes these.
What are temperature higher than 100° F (37.8° C), pain or tenderness over the grafted kidney, 2- to 3-lb (0.9 to 1.4 kg) weight gain in 24 hours, edema, hypertension, elevated blood urea nitrogen and serum creatinine levels, decreased creatinine clearance?
Patients with ESRD should be educated about this types of diet,
What are limit potassium and phosphorus, low sodium, low protein, eat smaller meals, limit processed foods, and high fiber diet.