A 74-year-old who is progressing to stage 5 chronic kidney ...

[kellyjaisingh]

A 74-year-old who is progressing to stage 5 chronic kidney disease asks the nurse, Do you think I should go on dialysis? Which initial response by the nurse is best?
 
  a. It depends on which type of dialysis you are considering.
  b. Tell me more about what you are thinking regarding dialysis.
  c. You are the only one who can make the decision about dialysis.
  d. Many people your age use dialysis and have a good quality of life.

Question 2

Which information will be included when the nurse is teaching self-management to a patient who is receiving peritoneal dialysis (select all that apply)?
 
  a. Avoid commercial salt substitutes.
  b. Drink 1500 to 2000 mL of fluids daily.
  c. Take phosphate-binders with each meal.
  d. Choose high-protein foods for most meals.
  e. Have several servings of dairy products daily.

[akpaschal]

Answer to Question 1

ANS: B
The nurse should initially clarify the patient's concerns and questions about dialysis. The patient is the one responsible for the decision and many people using dialysis do have good quality of life, but these responses block further assessment of the patient's concerns. Referring to which type of dialysis the patient might use only indirectly responds to the patient's question.

Answer to Question 2

ANS: A, C, D
Patients who are receiving peritoneal dialysis should have a high-protein diet. 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.