مريض غسيل كلوي منذ سنوات يشتكي آلاماً في العظام وحكة، والفوسفور مرتفع وهرمون الغدة جار الدرقية مرتفع. أي علاج يتوقعه الممرض؟

A long-term haemodialysis client has bone pain and itching with high phosphate and high parathyroid hormone. Which treatment does the nurse expect?

1. Daily phosphorus supplements to replace bone losses
2. More milk and cheese to strengthen bones directly
3. A phosphate binder with meals and active vitamin D as ordered
4. Stopping dialysis for a while to rest the bones and kidneys

Answer: C) A phosphate binder with meals and active vitamin D as ordered. Kidney failure raises phosphate and lowers active vitamin D, raising PTH and weakening bones. Treatment: phosphate restriction and binders, active vitamin D and sometimes specific agents.