Which of the following factors causes the nausea associated with renal failure?
A. Oliguria
B. Gastric ulcers
C. Electrolyte imbalances
D. Accumulation of waste products
Correct Answer: D. Accumulation of waste products
Although clients with renal failure can develop stress ulcers, the nausea is usually related to the poisons of metabolic wastes that accumulate when the kidneys are unable to eliminate them. Nausea and vomiting are very common in kidney patients and have many causes. These causes include the build-up of uremic toxins, medications, gastroparesis, ulcers, gastroesophageal reflux disease, gallbladder disease, and many many more.
Option A: The client has oliguria, but this doesn’t directly cause nausea. In patients with acute oliguria, one of the most common functional derangements that are observed is the sudden fall in the GRF, leading to acute renal failure. It results in rapid increment in plasma urea and creatinine levels, metabolic acidosis with hyperkalemia, other electrolyte abnormalities, and volume overload.
Option B: The occurrence and pathophysiology of peptic ulcer was studied in 117 uraemic patients. Ulcer disease was unusually frequent, and the highest incidence was found in patients on regular dialysis (48%). Factors implicated were hyperacidity, hypergastrinemia, and the effect of dialysis itself.
Option C: In renal failure, acute or chronic, one most commonly sees patients who have a tendency to develop hypervolemia, hyperkalemia, hyperphosphatemia, hypocalcemia, and bicarbonate deficiency (metabolic acidosis). Sodium is generally retained, but may appear normal, or hyponatremic, because of dilution from fluid retention.
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