ATI_AQ_MED-SURG_Endocrine

A nurse is reinforcing teaching with a client who has diabetes mellitus about food choices. Which of the following client statements indicates the teaching has been understood? A. "I will need to eliminate sweet desserts from my diet." B. "I should avoid using sucralose in my coffee." C. "I should consume alcohol between meals in moderation." D. "I should replace white bread with whole-grain bread."

"I should replace white bread with whole-grain bread." *Clients who have diabetes mellitus have the same fiber requirements as the general population. Fiber content can be increased by substituting white bread, which is made with refined grains, with whole-grain bread, which retains the outer layer of the grain that is higher in fiber

A nurse is reinforcing teaching with a client who has type 2 diabetes mellitus about foot care. Which of the following statements by the client indicates an understanding of the teaching? A. "I will apply moisturizer between my toes." B. "I will soak my feet daily." C. "I'll be sure to wear cotton socks every day." D. "I'll use a heating pad to warm my feet."

"I'll be sure to wear cotton socks every day." *The nurse should instruct the client to wear clean cotton socks every day to absorb moisture and reduce the risk of infection

A nurse is reinforcing teaching with a client who has type 2 diabetes mellitus about the pathophysiology of the disease. Which of the following statements by the client indicates an understanding of the teaching? A. "My cells are resistant to the effects of insulin." B. "My body breaks down sugars too efficiently." C. "My pancreas does not produce insulin." D. "My body produces antibodies against pancreatic beta cells."

"My cells are resistant to the effects of insulin." *This client who has type 2 diabetes mellitus will have resistance to insulin ad a decrease in the secretion of insulin by the pancreatic beta cells

A nurse is reinforcing teaching with a client who has a vaginal hysterectomy with a bilateral oophorectomy. Which of the following pieces of information should the nurse include in the teaching? A. "Plan to use some type of birth control for up to 6 weeks after surgery." B. "Use a water-based lubricant when having sexual intercourse." C. "Expect to have an increase in bloody vaginal drainage during the first 10 days after surgery." D. "Plan to start some type of aerobic exercise within a week after surgery."

"Use a water-based lubricant when having sexual intercourse." *Vaginal dryness is a manifestation of menopause after the ovaries are removed, and the client might require a water-based lubricant when having sexual intecourse

A nurse is reinforcing teaching with a client who has type 1 diabetes mellitus about exercise. Which of the following statements should the nurse include in the teaching? A. "You should exercise during a peak insulin time." B. "Wear a medical alert identification tag when you exercise." C. "Exercise can decrease the effects of insulin and cause the blood glucose levels to increase." D. "You will get the most benefit from exercise when your glucose levels are higher than normal."

"Wear a medical alert identification tag when you exercise." *The client should wear a medical alert identification tag in the event of a hypoglycemic response because exercise can potentiate the effects of insulin and cause the blood glucose levels to decrease

A nurse is reinforcing teaching with a client who has type 2 diabetes mellitus. The client states, "I eat pasta every day. I can't imagine giving it up." Which of the following responses should the nurse make? A. "Let's discuss this with your doctor; giving up pasta might not be necessary." B. "Is there another favorite dish you can substitute?" C. "You don't have to give up pasta; just adjust the amount you eat." D. "You can use no-added salt tomato products on your pasta."

"You don't have to give up pasta; just adjust the amount you eat." *The American Diabetes Association recommends individualizing carbohydrate restriction for each client. A careful evaluation of usual dietary practices and modifications is an important part of helping clients manage this disorder

A nurse is planning to administer fluids to a client who has 25% total body surface area burns. The client has no prior medical history. Which of the following intravenous fluids should the nurse identify as contraindicated for this client? A. Whole blood B. Lactated Ringer's C. Dextran 40 in 0.9% sodium chloride D. 0.45% sodium chloride

0.45% sodium chloride *The nurse should identify that 0.45% sodium chloride is a hypotonic solution and is contraindicated for clients who have burns. Hypotonic fluid has an osmolarity value of <270 mOsm/L, which is less than the expected reference range of the osmolarity value for plasma and body fluid of 285 to 295 m)sm/L. Administering a hypotonic solution to this client can cause third-spacing of fluid

A nurse is caring for a client who had a thyroidectomy to treat hyperthyroidism caused by adenoma. Which of the following findings should the nurse reports to the provider? (Select all that apply) A. Tachycardia and hypertension B. Respiratory rate 16/min C. Negative Chvostek's sign D. Laryngeal stridor and hoarseness E. Positive Trousseau's sign

1. Tachycardia and hypertension 2. Laryngeal stridor and hoarseness 3. Positive Trousseau's sign *A thyrotoxic crisis (thyroid storm) is a life-threatening condition with a sudden onset that includes tachycardia, a fever, sweating, restlessness, and tremors. Congestive heart failure and pulmonary edema can develop rapidly and lead to death. Tachycardia and hypertension are unexpected findings that can indicate the occurrence of thyroid storm following removal of the thyroid gland, especially if the client was in a hyperthyroid state prior to the surgery. Laryngeal stridor and hoarseness are unexpected findings and can indicate swelling in the area of the surgery or damage to the laryngeal nerve. This should be reported to the provider before respiratory distress develops. A positive Trousseau's sign is an indication of hypocalcemia, which is a complication of thyroid removal that occurs when the parathyroid glands are also removed and regulation of serum calcium is impaired

A nurse is contributing to the plan of care for a client who is scheduled to receive total parenteral nutrition (TPN). Which of the following actions should the nurse recommend including in the plan of care? (Select all that apply) A. Weight the client daily B. Obtain a serum blood glucose every 4 hours C. Apply a new dressing to the client's IV site every 5 days D. Change the IV tubing every 24 hours E. Monitor the TPN through a peripheral IV site

1. Weight the client daily 2. Obtain a serum blood glucose every 4 hours 3. Change the IV tubing every 24 hours *The nurse should recommend weighing the client daily while receiving TPN. Clients who are receiving TPN are typically malnourished; therefore, the client's weight needs to be monitored closely. Fluid retention can also be an indication that the client is not digesting the TPN, at which point the rate of transfusion might need to be decreased. Also, the nurse should recommend obtaining the client's serum blood hyperglycemia; insulin can be given if needed. Finally, the nurse should recommend changing the client's IV tubing every 24 hours to prevent bacteria from developing

A nurse is reinforcing dietary teaching with a client who has diabetes mellitus. Which of the following actions should the nurse take first? A. Obtain sample menus from the dietitian to give to the client B. Ask the client to identify the types of foods she prefers C. Identify the recommended range of the client's blood glucose level D. Discuss long-term complications that can result from nonadherence to the dietary plan

Ask the client to identify the types of foods she prefers *The nurse must first collect adequate data from the client. Therefore, the nurse should first ask the client about individual food preferences to provide an opportunity for the nurse to include these foods in her diet. Involving the client in the planning will help promote adherence to the dietary plan

A nurse is reviewing the laboratory values for a client who has hyperglycemic hyperosmolar nonketotic syndrome. Which of the following laboratory values is consistent with hyperglycemic hyperosmolar nonketotic syndrome? A. Blood glucose 320 mg/dL B. Positive urine ketones C. Blood pH 7.34 D. Blood osmolality >350 mOsm/kg

Blood glucose 320 mg/dL *A client who has hyperglycemic hyperosmolar nonketonic syndrome should have a blood glucose level >250 mg/dL, which will cause cause spilling of ketones in the urine and development of metabolic acidosis

A nurse is collecting data from a client who develops fruity breath odor, dry mouth, and extreme thirst. Which of the following additional data should the nurse collect? A. Blood glucose using a glucometer B. Pupillary reaction to light C. Deep tendon reflexes D. Liver function laboratory values

Blood glucose using a glucometer *The client's manifestations are indications of hyperglycemia and diabetic ketoacidosis. The nurse should check the client's blood glucose level, as well as respiratory status, vital signs, level of consciousness, and hydration status (including electrolyte levels)

A nurse is reviewing the laboratory reports for a client and notes an elevated thyroid-stimulating hormone (TSH) level. When collecting data from the client, which of the following findings should the nurse expect? A. Bradycardia B. Tremors C. Low-grade fever D. Diaphoresis

Bradycardia *An elevated TSH level indicates hypothyroidism, which is characterized by weight gain, bradycardia, cold intolerance, paresthesia, hearing loss, depression, and many other manifestations

A nurse is caring for a client who is postoperative following a parathyroidectomy to treat hyperparathyroidism. Which of the following laboratory values should the nurse expect to decrease as a therapeutic effect of the procedure? A. Phosphorus B. Sodium C. Potassium D. Calcium

Calcium *The parathyroid hormone regulates calcium, phosphorus, and magnesium balance within the client's blood and bone by maintaining a balance between mineral levels in blood and bone. Hyperparathyroidism is associated with hypercalcemia; therefore, a decrease in the calcium level indicates an improvement in the client's condition

A nurse is preparing a 24-hour urine specimen for a client with suspected pheochromocytoma. Which of the following laboratory tests from the 24-hour urine specimen should the nurse use to determine the client's condition? A. Creatinine clearance B. Catecholamine metabolites C. 17-hydroxycorticosteroids (17-OHCS) D. Protein

Catecholamine metabolites *The nurse should expect the 24-hour urine specimen to test for catecholamine metabolites, which is used to determine of the client has pheochromocytoma. This test measures the level of catecholamines (epinephrine and norepinephrine) secretion in a 24-hour urine sample. Pheochromocytoma is a tumor of the adrenal gland that causes excess release of the catecholamines, which are hormones that regulate blood pressure and heart rate

A nurse is assisting with the plan of care for a client who has Cushing's syndrome due to chronic corticosteroid use. Which of the following actions should the nurse include in the plan of care? A. Check the client's blood glucose for hypoglycemia B. Check for hypertension C. Weigh the client weekly D. Insert an indwelling urinary catheter

Check for hypertension *The nurse should check the client for hypertension, which can indicate fluid volume overload

A nurse is caring for a client who is posteoperative following a bilateral adrenalectomy. The nurse should expect to administer glucocorticoids following the procedure to enhance which of the following therapeutic effects? A. Compensate for decreased cortisol levels B. Inhibit glucose metabolism C. Act as a diuretic to maintain urine output D. Decrease susceptibility to infection

Compensate for decreased cortisol levels *With an adrenalectomy, the client requires glucocorticoids before, during, and after surgery to prevent an adrenal crisis caused by a sudden drop in cortisol levels. One of the hormones produced by the adrenal glands is cortisol, a glucocorticoid. Loss of glucocorticoid secretion leads to a state of altered metabolism and an inability to deal with stressors, which is fatal if untreated

A nurse is caring for a client who has type 1 diabetes mellitus and a capillary blood glucose reading of 48 mg/dL. Which of the following findings should the nurse expect? A. Kussmaul respirations B. Diaphoresis C. Decreased skin turgor D. Ketonuria

Diaphoresis *A nurse should expect a client who has a blood glucose level below 70 mg/dL to exhibit indications of hypoglycemia. Expected findings associated with hypoglycemia include weakness, huger, diaphoresis, nausea, shakiness, and confusion

A nurse is collecting data from a client who has Graves' disease. Which of the following findings should the nurse expect the client to display? A. Constipation B. Cold intolerance C. Difficulty sleeping D. Anorexia

Difficulty sleeping *A client who has Graves' disease can have difficulty sleeping and anxiety due to the overproduction of thyroid hormone

A nurse is assisting with the plan of care for a client who has type 2 diabetes mellitus. Which of the following interventions should the nurse include in the plan? A. Encourage the client to control weight B. Inspect the client's feet once each week C. Restrict the client's activity D. Apply moisturizer between the client's toes

Encourage the client to control weight *The nurse should encourage weight control to stabilize blood glucose and improve glycosylated hemoglobin levels. Obesity is a risk factor for type 2 diabetes, and moderate calorie restriction can improve control of diabetes

A nurse is reviewing laboratory results for a client who has diabetes mellitus. Which of the following results indicates that the client is controlling the diabetes? A. HbA1c 8.5% B. Postprandial blood glucose 190 mg/dL C. Casual blood glucose 205 mg/dL D. Fasting blood glucose 95 mg/dL

Fasting blood glucose 95 mg/dL *The nurse should identify that a fasting blood glucose of 95 mg/dL is within the expected reference range of 70 to 110 mg/dL, which indicates that the client has the diabetes under control

A nurse is checking a client with Graves' disease for the development of thyroid storm. The nurse should report which of the following findings to the provider? A. Constipation B. Headache C. Bradycardia D. Fever

Fever *A client who is experiencing a thyroid storm will have an exaggerated condition of hyperthyroidism associated with the sudden development of an extreme elevation in body temperature, hypertension, abdominal pain, and tachycardia. Graves' disease is a common cause of hyperthyroidism, which is an imbalance of metabolism caused by overproduction of thyroid hormone

A nurse is checking laboratory values to determine if a client who has diabetes mellitus is adhering to the treatment plan. Which of the following tests should the nurse use to make this determination? A. Glucose tolerance test B. Urine sugar and acetone C. Glycosylated hemoglobin levels D. Fasting serum glucose

Glycosylated hemoglobin levels *Checking glycosylated hemoglobin levels (HbA1c) is an accurate method to determine if the client is routinely compliant. Glycosylated hemoglobin refers to hemoglobin that is connected to glucose. Since the lifespan of an RBC is 4 months, this value will not be affected by affected by recent changes in the client's diet or medication

A nurse is assisting with the care of a client who has Addison's disease and comes to the emergency department reporting nausea, vomiting, diarrhea, and abdominal pain. To prevent an Addisonian crisis, the nurse should expect the provider to prescribe which of the following medications? A. Calcium B. Potassium C. Iodine D. Hydrocortisone

Hydrocortisone *Addison's disease causes adrenal gland hypofunction and inadequate production of glucocorticoids. Acute adrenal insufficiency is life-threatening due to severe fluid and electrolyte imbalances. Without treatment sodium levels fall, and potassium levels in crease. Rapid infusion of IV fluids such as 0.9% sodium chloride and IV administration of high-dose corticosteroids such as hydrocortisone are essential to correct the glucocorticoid deficiency

A nurse is assisting with the care of a client who has Addison's disease and was admitted with muscle weakness and dehydration, as well as nausea and vomiting for the past 2 days. Which of the following prescribed medications should the nurse plan to administer? A. Rifampin B. Loperamide C. Hydrocortisone D. Spironolactone

Hydrocortisone *This client with Addison's disease will require hydrocortisone to assist with replacing cortisol levels. A client who has Addison's disease has adrenal corticoid insufficiency, which is the inability of the pituitary to produce cortisol. Illness and stress can require steroids such as hydrocortisone to restore hormone levels. An Addisonian crisis can cause sudden destruction to the adrenal gland or pituitary and be life-threatening

A nurse is assisting with the care of a client who has been diagnosed with an Addisonian crisis and has a blood pressure of 74/42 mmHg. Which of the following medication prescriptions should the nurse anticipate? A. Desmopressin B. Hydrocortisone C. Dopamine D. Furosemide

Hydrocortisone *This client with Addison's disease will require hydrocortisone to assist with replacing cortisol levels. A client who has Addison's disease has adrenal corticoid insufficiency, which is the inability of the pituitary to produce cortisol. Illness and stress can require steroids such as hydrocortisone to restore hormone levels. An Addisonian crisis can cause sudden destruction to the adrenal gland or pituitary and be life-threatening

A nurse is conducting a home visit with an older adult client who has diabetes mellitus and takes regular insulin subcutaneously before each meal. The client appears disoriented and weak and has slurred speech. Which of the following conditions should the nurse consider first when responding to these manifestations? A. Dementia B. Hypoglycemia C. Infection D. Transient ischemic attack

Hypoglycemia *Evidence-based practice indicates that the nurse should first check the client for hypoglycemia by drawing a blood glucose level. A client who has hypoglycemia can have slurred speech, disorientation, weakness, and confusion near mealtimes each day because regular insulin peaks in 2 to 4 hours, causing a drop in the client's blood glucose. Other manifestations of hypoglycemia include irritability, mental confusion, double vision, hunger, tachycardia, diaphoresis, and palpitations

A nurse is monitoring a client who has syndrome of inappropriate antidiuretic hormone secretion (SIADH). Which of the following findings should the nurse expect? A. Polyuria B. Dehydration C. Hyponatremia D. Hyperthermia

Hyponatremia *This client with SIADH will have hyponatremia caused by the excessive release of antidiuretic hormone (ADH). As a result of the excess ADH, the client retains water, which causes dilutional hyponatremia

A nurse is collecting data from a client who has Addison's disease. Which of the following findings should the nurse expect? A. Hypotension B. Weight gain C. Sugar craving D. Pale skin tone

Hypotension *The nurse should expect hypotension in a client who has adrenal insufficiency (Addison's disease). The nurse should monitor the client's blood pressure closely. If an Addisonian crisis occurs, the client's hypotension can become severe due to blood volume depletion caused by the loss of aldosterone

A nurse is reviewing the dietary choices of a client who has chronic pancreatitis. Which of the following food items should the nurse suggest removing from the client's dietary choices for the following day? A. White rice B. Boiled cod C. Ice cream D. Canned peaches

Ice cream *Clients who have chronic pancreatitis should limit their fat intake to no more than 30% to 40% of their total calories. Ice cream is high in fat, with 48 g of fat in a 1-cup serviing of vanilla ice cream. The client should choose healthier options to support a balanced diet such as avocados and nuts

A nurse is reinforcing teaching with a client who has hyperthyroidism about managing this disorder. Which of the following recommendation should the nurse include? A. Reduce her total hours of sleep B. Keep her immediate environment warm C. Increase her caloric intake with meals D. Gradually increase her activity

Increase her caloric intake with meals *Clients whose thyroid hormone levels are high have increased protein, lipid, and carbohydrate metabolism, resulting in loss of protein stores and a negative nitrogen balance. Even with an increased appetite, it is often difficult to meet energy demands, and weight loss is common. Muscle weakness and wasting can develop without adequate caloric and protein intake

A nurse is collecting data from a client who has manifestations of acromegaly. Which of the following findings should the nurse expect? A. Thinning of skeletal bone structure B. Concave chest wall C. High-pitched voice D. Increase head size

Increased head size *A client who has acromegaly will manifest an enlarged head size due to the excessive production of growth hormones after closing of the epiphyses (the "growth plate" at the ends of the long bones) by the pituitary gland. This condition results in the gradual enlargement of the client's body tissues such as the bones of the face, jaw, hands, feet, and skull

A nurse is caring for a client who has type 2 diabetes mellitus and is displaying manifestations of hyperglycemia. Which of the following findings indicate that the client has hyperglycemia? A. Hunger B. Increased urination C. Cold, clammy skin D. Tremors

Increased urination *Increased urination (polyuria) is a manifestation of hyperglycemia due to a deficiency of insulin, which can lead to osmotic diuresis

A nurse is monitoring a client following a thyroidectomy. Which of the following findings should the nurse identify as an indication of hypoparathyroidism? A. Elevated blood pressure B. Involuntary muscle spasms C. Cold intolerance D. Weight loss

Involuntary muscle spasms *The nurse should identify involuntary muscle spams as an indication of hypoparathyroidism, which can occur if the parathyroid glands are damaged or removed during a thyroidectomy. Muscle twitching and paresthesias can result due to decreased parathyroid hormone levels and calcium deficiency

A nurse is reinforcing teaching with a client who has type 1 diabetes mellitus about hypoglycemia. Which of the following manifestations should the nurse include in the teaching? A. Irritability B. Urinary frequency C. Dry mucous membranes D. Excess thirst

Irritability

A nurse is caring for a client who has diabetic ketoacidosis (DKA). Which of the following findings should the nurse expect? A. Urine negative for ketones B. Distended neck veins C. Kussmaul respirations D. Elevated blood pressure

Kussmaul respirations *The nurse should expect the client to experience Kussmaul respirations with DKA. These deep and rapid respirations are the body's attempt to exhale carbon dioxide to reverse the metabolic acidosis that occurs with DKA

A nurse is assisting with a plan for community health screening for a group of clients who are at risk for type 2 diabetes mellitus. Which of the following client groups should the nurse include in the screening? A. Men who smoke B. Men and women who are obese C. Women who have hepatitis D. Men and women who consume high-protein and low-carbohydrates

Men and women who are obese *There is a high correlation between obesity and type 2 diabetes mellitus. Obesity plays a major role in the development of type 2 diabetes mellitus by decreasing the number of available insulin receptors in skeletal muscles and fat cells, which is referred to as peripheral insulin resistance. A reduced-calorie diet for obese clients tends to reverse the phenomenon of peripheral insulin resistance

A nurse is assisting with the plan of care for a client who is experiencing the Somogyi effect and takes intermittent-acting insulin. Which of the following actions should the nurse include in the plan? A. Move the client's evening intermediate-acting insulin dose to 90 minutes before dinner B. Increase the client's morning caloric intake C. Omit the client's evening snack D. Monitor the client's nighttime blood glucose levels

Monitor the client's nighttime blood glucose levels *The Somogyi effect is a swing of a high blood glucose level in the morning after an extremely low blood glucose level during the night. This swing is caused by the release of stress hormones to counter low glucose levels. Monitoring the client's nighttime blood glucose levels can provide an accurate diagnosis of the Somogyi effect

A nurse in an urgent care center is collecting data from an infant who has laryngotracheobronchitis. Which of the following findings should the nurse report to the provider as an indication of impending airway obstruction? A. Bradycardia B. Respiratory depression C. Nasal flaring D. Barking cough

Nasal flaring *Acute laryngotracheobronchitis (croup) causes dyspnea and swelling of the upper airway. Indications of impending airway instruction include tachycardia, increasing restlessness, flaring nares, and intercostal retraction

A nurse is caring for a client who has urolithiasis and requires further diagnostic testing after an initial assessment indicated hypercalcemia. The nurse should explain that which of the following structures controls calcium concentration? A. Pancreas B. Thyroid gland C. Anterior pituitary gland D. Parathyroid gland

Parathyroid gland *The parathyroid gland secretes parathyroid hormones, which help the kidneys reabsorb calcium and increase calcium absorption from the gastrointestinal tract

A nurse is caring for a client who has diabetes insipidus. For which of the following findings should the nurse monitor? A. Proteinuria B. Oliguria C. Polyuria D. Glycosuria

Polyuria *Diabetes insipidus is characterized by increased thirst (polydipsia) and increased urination (polyuria). A client who has diabetes insipidus will excrete large quantities of urine with a very low specific gravity

A nurse is collecting data from a client who is recovering from a thyroidectomy and has harsh, high-pitched respiratory sounds. Which of the following actions should the nurse take? A. Hyperextend the client's neck B. Prepare for a tracheostomy C. Lower the head of the bed D. Administer morphine

Prepare for a tracheostomy *The nurse should notify the provider immediately and prepare for a tracheostomy. Laryngeal stridor is a high-pitched, harsh breathing sound that indicates respiratory distress due to swelling, tetany, or laryngeal spasms

A nurse is collecting data from a client who has Cushing's syndrome. Which of the following skin manifestations should the nurse expect to find? A. Purple striae on the chest and abdomen B. Butterfly rash across the bridge of the nose C. Bronze skin pigmentation D. Jaundice of the face and sclera

Purple striae on the chest and abdomen *A client who has Cushing's disease should have purple striae (streaks or stripes) on the chest and abdomen because cortisol destroys collagen under the skin

A nurse is preparing for the transfer of a client from the postanesthesia care unit (PACU) following a subtotal thyroidectomy. Which of the following pieces of equipment should the nurse have available at the client's bedside? A. Cardiac monitor B. Defibrillator C. Thoracotomy tray D. Tracheostomy tray

Tracheostomy tray *Due to the laryngeal edema that is common after a thyroidectomy, respiratory distress could result in airway obstruction. Emergency intubation can be difficult due to laryngeal swelling, and endotracheal intubation can increase the risk of hemorrhage by raising tension on the incision during insertion. The nurse should have a tracheostomy tray available for this client

A nurse is reinforcing teaching with a client who has Addison's disease about healthy snacks. Which of the following food choices by the client indicates an understanding of the teaching? A. Sliced bananas B. Baked potato C. Turkey and cheese sandwich D. Plain yogurt with peaches

Turkey and cheese sandwich *A turkey and cheese sandwich is high in protein, carbohydrates, and sodium. A client who has Addison's disease requires a diet that is low in potassium and high in sodium, carbohydrates, and protein. Addison's disease is a hormone deficiency caused by damage to the outer layer of the adrenal gland (Adrenal cortex). Addison's disease occurs when the adrenal glands do not produce enough cortisol and, in some cases, aldosterone.

A nurse is caring for a client who is scheduled to receive peritoneal dialysis. Which of the following actions should the nurse take? A. Warm the dialysate solution to room temperature prior to administration B. Cleans the catheter site using a back-and-forth motion beginning at the end of the catheter and moving inward C. Place the drainage bag at the level of the client's chest D. Apply clean gloves and cleanse the client's catheter site with cold water

Warm the dialysate solution to room temperature prior to administration *The nurse should warm the dialysate solution to room temperature prior to administration. This prevents the client from experiencing pain and abdominal cramping due to a cold solution during dialysis