A client is diagnosed with chronic renal failure and told she must start hemodialysis. Client teaching would include which of the following instructions?
A. Follow a high potassium diet.
B. Strictly follow the hemodialysis schedule.
C. There will be a few changes in your lifestyle.
D. Use alcohol on the skin and clean it due to integumentary changes.
Correct Answer: B. Strictly follow the hemodialysis schedule.
To prevent life-threatening complications, the client must follow the dialysis schedule. Compliance in hemodialysis patients is most often measured by monitoring levels of blood urea nitrogen, potassium, and phosphorus and by observing the amount of weight gain between dialysis treatments. The most compliant patients tend to be married, skilled professionals with a high level of self-concept.
Option A: The client should follow a low-potassium diet because potassium levels increase in chronic renal failure. In regimens requiring alterations of critical behavior, such as diet, changes should be made one at a time, with the next objective being added only after the patient has demonstrated adequate knowledge of the preceding step.
Option C: The client should know hemodialysis is time-consuming and will definitely cause a change in his or her current lifestyle. To improve compliance, health professionals need to assess fully the educational level and understanding of the patient.
Option D: Alcohol would further dry the client’s skin more than it already is. Compliance with dietary, fluid, and medication instruction is a critically significant factor in the continued health and well-being of the patient undergoing chronic hemodialysis.
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