The nurse is teaching the client with renal failure about hemodialysis (HD). Which does the nurse omit from client teaching regarding client lifestyle with HD?

Question

1. Drink plenty of liquids to satisfy thirst.
2. Daily protein intake is very restricted.
3. Report shortness of breath to provider.
4. A-V fistula should not have drainage.

Answer 1

1
1. The nurse instructs the client to adhere to daily fluid restrictions despite thirstiness as part of the therapeutic regimen for renal failure. Although HD effectively removes excess fluid volume, the client risks potential organ damage by exposing himself to fluid volume overload. Renal failure is associated with other major organ damage, so the client is accelerating the potential decline in his health with excessive fluid intake. In addition, by increasing the excess fluid volume HD must remove for the client, the client aggravates the already massive fluid shifts that occur during HD and risks severe hemodynamic instability and seizures.
2, 3, and 4. Protein restrictions help to limit the byproducts of protein metabolism (nitrogen in the form of urea, uric acid, creatinine, and ammonia), which is the pri-mary problem of renal failure.
3. The nurse instructs the client to report shortness of breath because it is consistent with clinical indicators of fluid volume overload.
4. The fistula should have no drainage after it is healed; if the client observes drainage from the fistula, he knows to report it.