The nurse is caring for a client with chronic renal disease who ...

[penza]

The nurse is caring for a client with chronic renal disease who is pale and experiencing fatigue. The nurse attributes these symptoms to anemia secondary to chronic renal disease. The client's spouse asks why the client is anemic.
 
  Which response by the nurse is the most appropriate?
  A) Your spouse has a genetic tendency for the development of anemia.
  B) The increased metabolic waste products in the body depress the bone marrow and cause anemia.
  C) There is a decreased production by the kidneys of the hormone erythropoietin which is the cause of anemia.
  D) The client is not eating enough iron-rich foods which is causing anemia.

Question 2

The nurse is caring for a client from another country who was admitted with hypertension and chronic renal failure. The client is receiving hemodialysis three times a week. The nurse is assessing the client's diet and the client reports the use of salt su
 
  When teaching the client to avoid salt substitute, which rationale supports this teaching point?
  A) They will increase the risk of AV fistula infection.
  B) They will cause the client to retain fluid.
  C) They will interact with the client's antihypertensive medications.
  D) They can potentiate hyperkalemia.

[Liamb2179]

Answer to Question 1

Answer: C

Anemia is common in clients with renal disease. Among the factors causing the anemia are decreased production of erythropoietin by the kidneys and shortened red blood cell (RBC) life. Erythropoietin is involved in the stimulation of the bone marrow to produce RBCs. Metabolic wastes do not suppress the bone marrow. Diet and heredity do not factor into the production of erythropoietin.

Answer to Question 2

Answer: D

Many salt substitutes use potassium chloride. Potassium intake is carefully regulated in clients with renal failure, and the use of salt substitutes will worsen hyperkalemia. Increases in weight do need to be reported to the healthcare provider as a possible indication of fluid volume excess, but this is not the reason why salt substitute is to be avoided. The control of hypertension is essential in the management of a client with kidney disease, but salt substitute is not known to interact with antihypertensive medications. An AV fistula does need to be protected from injury and infection could be caused by constricting clothing, venipunctures, and other items.

[penza]

TYSM

[AmberC1996]

Excellent