Kidney care, dialysis and fluid balance
Study individualized kidney nutrition, dialysis access, infection warnings and medicine safety. Use laboratory and clinical trends together.
Practice this collectionIndividualize the kidney diet
Does every person with CKD need the same food restrictions?
NCLEX-RN clinical recall · connect this concept to the patient’s assessment and care plan.
Response and reasoning
No. Tailor intake to kidney function, laboratory results, treatment and nutritional needs.
CKD nutrition is individualized.
Use the clinical context and the prescribed care plan when applying this principle.
NIDDK · Healthy eating with CKD · Source accessed 2026-10-17 · Concept version 1
Save and practice this conceptCheck salt substitutes
Why should potassium-containing salt substitutes be reviewed in CKD?
NCLEX-RN clinical recall · connect this concept to the patient’s assessment and care plan.
Response and reasoning
They can raise potassium exposure when kidney excretion is impaired.
Potassium-containing substitutes may worsen hyperkalemia.
Use the clinical context and the prescribed care plan when applying this principle.
NIDDK · Healthy eating with CKD · Source accessed 2026-10-17 · Concept version 1
Save and practice this conceptRecognize potassium urgency
Why is severe hyperkalemia dangerous?
NCLEX-RN clinical recall · connect this concept to the patient’s assessment and care plan.
Response and reasoning
It can disrupt cardiac conduction and requires urgent assessment and prescribed treatment.
Potassium disturbances can cause life-threatening arrhythmias.
Use the clinical context and the prescribed care plan when applying this principle.
National Kidney Foundation · Potassium · Source accessed 2026-10-17 · Concept version 1
Save and practice this conceptProtect dialysis access
How should an arm containing a functioning AV fistula be protected?
NCLEX-RN clinical recall · connect this concept to the patient’s assessment and care plan.
Response and reasoning
Avoid routine blood pressure cuffs and venipuncture on the access arm.
Avoiding compression helps protect the access.
Use the clinical context and the prescribed care plan when applying this principle.
MedlinePlus · Hemodialysis access care · Source accessed 2026-10-17 · Concept version 1
Save and practice this conceptNotice loss of access flow
What if the usual fistula vibration is absent?
NCLEX-RN clinical recall · connect this concept to the patient’s assessment and care plan.
Response and reasoning
Contact the dialysis team immediately for assessment of possible access obstruction.
Absent thrill may indicate compromised access flow.
Use the clinical context and the prescribed care plan when applying this principle.
MedlinePlus · Hemodialysis access care · Source accessed 2026-10-17 · Concept version 1
Save and practice this conceptRecognize peritonitis risk
What is concerning about cloudy peritoneal dialysis effluent?
NCLEX-RN clinical recall · connect this concept to the patient’s assessment and care plan.
Response and reasoning
Cloudiness with abdominal pain may indicate infection; contact the dialysis team promptly.
Cloudy effluent with pain suggests peritonitis; the team may request a specimen.
Use the clinical context and the prescribed care plan when applying this principle.
NIDDK · Peritoneal dialysis · Source accessed 2026-10-17 · Concept version 1
Save and practice this conceptProtect the dialysis connection
What should happen when sterile connection technique is broken?
NCLEX-RN clinical recall · connect this concept to the patient’s assessment and care plan.
Response and reasoning
Pause and follow the dialysis team’s contamination protocol rather than use a contaminated connection.
The team’s protocol addresses contamination before fluid is infused.
Use the clinical context and the prescribed care plan when applying this principle.
NIDDK · Peritoneal dialysis · Source accessed 2026-10-17 · Concept version 1
Save and practice this conceptReview OTC kidney risks
Why are NSAIDs concerning during dehydration?
NCLEX-RN clinical recall · connect this concept to the patient’s assessment and care plan.
Response and reasoning
They can contribute to acute kidney injury; review safe medication choices with the care team.
Dehydration increases NSAID-associated kidney risk.
Use the clinical context and the prescribed care plan when applying this principle.
NIDDK · Keeping kidneys safe with medicines · Source accessed 2026-10-17 · Concept version 1
Save and practice this conceptUse complementary kidney tests
Why are both blood and urine tests used to assess kidney disease?
NCLEX-RN clinical recall · connect this concept to the patient’s assessment and care plan.
Response and reasoning
eGFR estimates filtration; urine albumin helps identify kidney damage.
Albumin leakage and filtration assess different aspects of kidney health.
Use the clinical context and the prescribed care plan when applying this principle.
NIDDK · CKD tests and diagnosis · Source accessed 2026-10-17 · Concept version 1
Save and practice this conceptRecognize upper urinary infection
What changes suggest infection beyond the bladder?
NCLEX-RN clinical recall · connect this concept to the patient’s assessment and care plan.
Response and reasoning
Fever or chills with flank pain and urinary symptoms warrants prompt evaluation.
Systemic symptoms with flank pain raise concern for kidney infection.
Use the clinical context and the prescribed care plan when applying this principle.
NIDDK · Kidney infection symptoms · Source accessed 2026-10-17 · Concept version 1
Save and practice this conceptReview medicines as function changes
Why may medication doses need review when kidney function declines?
NCLEX-RN clinical recall · connect this concept to the patient’s assessment and care plan.
Response and reasoning
Some medicines or metabolites accumulate when renal clearance falls.
Reduced clearance can change a medicine’s safe use.
Use the clinical context and the prescribed care plan when applying this principle.
NIDDK · Managing chronic kidney disease · Source accessed 2026-10-17 · Concept version 1
Save and practice this conceptTrack fluids between treatments
Why follow an individualized fluid plan during hemodialysis?
NCLEX-RN clinical recall · connect this concept to the patient’s assessment and care plan.
Response and reasoning
Extra fluid can accumulate between treatments and affect breathing and blood pressure.
Dialysis is intermittent and fluid needs are individualized.
Use the clinical context and the prescribed care plan when applying this principle.
NIDDK · Hemodialysis · Source accessed 2026-10-17 · Concept version 1
Save and practice this conceptSources
Use these notes to study clinical concepts. In patient care, follow the setting's emergency response and treatment protocols.