ESTUDYR
NCLEX-RN Case Study: Chronic Kidney
Disease (CKD)
Client Scenario
0900 Nurses' Notes:
A 62-year-old female with a history of Stage 5 CKD and Hypertension is admitted to the
medical unit. She missed her last two scheduled hemodialysis sessions due to a lack of
transportation. She reports feeling "extremely weak" and is experiencing "skipped
heartbeats."
Physical Assessment:
Cardiovascular: Irregular heart rhythm; 2+ pitting edema in bilateral ankles. A loud
bruit and palpable thrill are noted over the left forearm arteriovenous (AV) fistula.
Respiratory: Lung sounds are clear.
Vital Signs: BP 172/94, HR 54 (irregular), RR 18, SpO2 95% on Room Air.
Item 1: Recognizing Cues
Question: Click to highlight the findings that require immediate intervention to prevent a
life-threatening event.
Findings: 62-year-old female; missed last two hemodialysis sessions; feeling "extremely
weak"; experiencing "skipped heartbeats"; BP 172/94; HR 54 (irregular); bruit and thrill
noted.
Rationale: Missing dialysis in Stage 5 CKD leads to the dangerous accumulation of potassium
and fluid. "Skipped heartbeats," weakness, and an irregular, slow heart rate (bradycardia)
are classic indicators of Hyperkalemia, which can cause sudden cardiac arrest.
Item 2: Analyzing Cues
Question: The nurse reviews the laboratory results. Which results are expected for this
client? (Select All That Apply)
NCLEX-RN Case Study: Chronic Kidney
Disease (CKD)
Client Scenario
0900 Nurses' Notes:
A 62-year-old female with a history of Stage 5 CKD and Hypertension is admitted to the
medical unit. She missed her last two scheduled hemodialysis sessions due to a lack of
transportation. She reports feeling "extremely weak" and is experiencing "skipped
heartbeats."
Physical Assessment:
Cardiovascular: Irregular heart rhythm; 2+ pitting edema in bilateral ankles. A loud
bruit and palpable thrill are noted over the left forearm arteriovenous (AV) fistula.
Respiratory: Lung sounds are clear.
Vital Signs: BP 172/94, HR 54 (irregular), RR 18, SpO2 95% on Room Air.
Item 1: Recognizing Cues
Question: Click to highlight the findings that require immediate intervention to prevent a
life-threatening event.
Findings: 62-year-old female; missed last two hemodialysis sessions; feeling "extremely
weak"; experiencing "skipped heartbeats"; BP 172/94; HR 54 (irregular); bruit and thrill
noted.
Rationale: Missing dialysis in Stage 5 CKD leads to the dangerous accumulation of potassium
and fluid. "Skipped heartbeats," weakness, and an irregular, slow heart rate (bradycardia)
are classic indicators of Hyperkalemia, which can cause sudden cardiac arrest.
Item 2: Analyzing Cues
Question: The nurse reviews the laboratory results. Which results are expected for this
client? (Select All That Apply)
