HESI Basic Care and Comfort Practice Exam

In clients with end-stage renal disease (ESRD), renal dysfunction can manifest through a variety of clinical signs, but one significant indicator is hypertension. The kidneys play a crucial role in regulating blood pressure by managing fluid balance and electrolyte levels. When the kidneys are failing, they lose their ability to excrete excess fluids and control the levels of electrolytes, particularly sodium. This can lead to fluid overload and increased blood volume, resulting in elevated blood pressure.

While hyperkalemia, edema, and hypoglycemia can also be associated with renal dysfunction, they are not as definitive as hypertension in the context of ESRD. Hyperkalemia involves high potassium levels, which can arise from renal failure, but it is not a direct measurement of renal function in the same way blood pressure is indicative. Edema can also occur due to fluid retention but is a symptom rather than a specific sign of renal dysfunction. Hypoglycemia is not commonly related to renal failure and may occur due to other reasons unrelated to kidney function.

Thus, hypertension is a key sign that indicates renal dysfunction in clients with end-stage renal disease, as it directly correlates with the kidneys' failure to effectively regulate blood volume and pressure.