A 37-year-old client diagnosed with chronic kidney disease (CKD) is being treated for renal osteodystrophy. Which nursing diagnosis is most likely to be included in this client’s plan of care?
A.
Hygiene self-care deficit related to uremic frost.
B.
High risk for infection related to subclavian catheter.
C.
High risk for injury related to ambulation.
D.
Knowledge deficit related to high-protein diet.
The correct answer and Explanation is :
The correct answer is B. High risk for infection related to subclavian catheter.
Explanation:
Chronic kidney disease (CKD) can lead to various complications, including renal osteodystrophy, which is a bone disorder caused by imbalances in calcium, phosphate, and vitamin D due to reduced kidney function. While all the nursing diagnoses listed could potentially be relevant to a CKD patient, the most critical one in this context is the high risk for infection related to subclavian catheter.
Rationale:
- Risk Factors for Infection: Patients with CKD often require dialysis, and a subclavian catheter is frequently used for this purpose. The presence of any catheter increases the risk of infection, particularly due to the potential for introducing pathogens into the bloodstream. Infection control measures are paramount in these cases to prevent complications like catheter-related bloodstream infections (CRBSIs).
- Clinical Implications: If an infection develops, it can lead to severe complications, including sepsis, which is particularly dangerous for a patient with already compromised renal function. The presence of infection can further hinder kidney function and complicate the management of CKD and its associated conditions.
- Prioritization in Nursing Care: When developing a nursing care plan, it’s essential to prioritize diagnoses based on the severity and immediacy of risks. A high risk for infection poses a direct threat to the patient’s health and must be monitored closely. This would involve regular assessment of the catheter site, monitoring for signs of infection, and educating the patient on signs and symptoms to report.
In contrast, while options A, C, and D address important aspects of care, they do not represent as immediate a risk to the patient’s safety as option B. Therefore, focusing on preventing infection is critical in managing a patient with CKD and a subclavian catheter.