A patient with chronic renal failure receives hemodialysis ...

[madam-professor]

A patient with chronic renal failure receives hemodialysis treatments 3 days a week. Every 2 weeks, the patient requires a transfusion of 1 or 2 U of packed red blood cells. What is the probable reason for this patient's frequent transfusion needs?
 
  a. Too much blood phlebotomized for tests
  b. Increased destruction of red blood cells because of the increased toxin levels
  c. Lack of production of erythropoietin to stimulate red blood cell formation
  d. Fluid retention causing hemodilution

Question 2

The patient's ICP reading has gradually climbed from 15 to 23 mm Hg. The nurse's primary action is to
 
  a. drain off 7 mm of CSF from the catheter.
  b. notify the physician.
  c. place the patient in a high Fowler position to decrease the pressure.
  d. check level of consciousness.

[ebe]

Answer to Question 1

C
In chronic renal failure, the kidneys do not produce sufficient amounts of erythropoietin in response to normal stimuli such as anemia or hypotension. The other choices are not reasons for frequent blood transfusions in this patient.

Answer to Question 2

B
Under normal physiologic conditions, mean intracranial pressure (ICP) is maintained below 15 mm Hg. An increase in ICP can decrease blood flow to the brain, causing brain damage. Persistent ICP elevation above 20 mm Hg remains the most significant factor associated with a fatal outcome.

[madam-professor]

Excellent

[kjohnson]

TYSM