A client is diagnosed with chronic kidney disease and needs to begin dialysis. Which condition entered on the client's medical record should the nurse recognize as a contraindication for peritoneal dialysis?
Latent hepatitis C.
Crohn's disease with colectomy.
Nephrotic syndrome history.
Type 2 diabetes mellitus.
The Correct Answer is B
A. Latent hepatitis C is not an absolute contraindication for peritoneal dialysis, and patients with this condition can often undergo dialysis with appropriate precautions.
B. Crohn's disease with a history of colectomy poses a risk for peritoneal dialysis due to potential intra-abdominal adhesions and infection, which can complicate the procedure and increase the risk of peritonitis.
C. A history of nephrotic syndrome does not contraindicate peritoneal dialysis; patients with nephrotic syndrome may still be candidates depending on their overall kidney function and health status.
D. Type 2 diabetes mellitus is a common condition among patients needing dialysis and does not preclude the use of peritoneal dialysis, as long as blood sugar levels are managed effectively.
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Correct Answer is C
Explanation
A. Bradycardia and constipation are symptoms associated with hypothyroidism, not hyperthyroidism, indicating that the dosage may be too low rather than too high.
B. Muscle cramping and dry, flushed skin are not typical indicators of levothyroxine overdose and may reflect other underlying issues.
C. Palpitations and shortness of breath are symptoms indicative of hyperthyroidism, suggesting that the levothyroxine dosage may be too high, leading to an increased metabolic rate and cardiovascular stress.
D. Lethargy and lack of appetite are more consistent with under-treatment or hypothyroidism rather than an overdose of levothyroxine, which typically stimulates metabolic activity.
Correct Answer is D
Explanation
A. Joint pain is a common symptom of systemic lupus erythematosus (SLE) and, while it may indicate an exacerbation of the disease, it is not the most critical finding to report.
B. A low-grade fever can signify an infection or increased disease activity but is generally not as urgent as changes in renal function or systemic involvement.
C. Muscle atrophy is a concern over time but does not pose an immediate threat to the client’s health compared to acute changes in kidney function.
D. Hematuria is significant in SLE as it can indicate renal involvement, such as lupus nephritis, which can lead to severe complications. This finding requires prompt reporting and assessment to prevent further renal damage and manage potential complications effectively.