A male client with chronic kidney disease (CKD) is refusing to take his medication and has missed two hemodialysis appointments. What is the best initial action for the nurse?
a. Discuss what the treatment regimen means to him.
b. Refer the client to a mental health nurse practitioner.
c. Reschedule the appointments to another date and time.
d. Discuss the option of peritoneal dialysis.
ANS: A
The initial action for the nurse is to assess anxiety, coping styles, and the client's acceptance of the required treatment for CKD. The client may be in denial of the diagnosis. While rescheduling hemodialysis appointments may help, and referral to a mental health practitioner and the possibility of peritoneal dialysis are all viable options, assessment of the client's acceptance of the treatment should come first.
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