Pharmacology Proctored ATI Practice Exam

A client with ESKD experiences shortness of breath and swelling in the lower extremities. What should the nurse suspect?

1. Pneumonia

2. Hypervolemia

3. Pulmonary embolism

4. Anemia

The correct answer is: Hypervolemia

In a client with end-stage kidney disease (ESKD) experiencing shortness of breath and swelling in the lower extremities, the nurse should suspect hypervolemia. ESKD can lead to the retention of fluids and electrolytes in the body due to impaired kidney function, resulting in fluid overload or hypervolemia. This can manifest as shortness of breath due to fluid accumulation in the lungs and swelling in the lower extremities (edema) due to fluid retention in the tissues. Monitoring for signs of hypervolemia and implementing appropriate interventions such as diuretics and fluid restrictions are essential in managing this condition. Option A (Pneumonia) is incorrect because the symptoms described are more indicative of fluid overload rather than a respiratory infection like pneumonia. Option C (Pulmonary embolism) is incorrect as this condition presents with symptoms such as chest pain, shortness of breath, and sometimes coughing up blood. While shortness of breath is a common symptom, the swelling in the lower extremities is not typically associated with a pulmonary embolism. Option D (Anemia) is incorrect as anemia would not typically present with both shortness of breath and swelling in the lower extremities. Anemia symptoms commonly include fatigue, weakness, and pallor due to a decrease in red blood cells or hemoglobin levels.