A nurse is collecting data from a client who has end-stage kidney disease and is waiting for transport to dialysis. Which of the following findings should the nurse expect?

A. Facial flushing: Facial flushing is often associated with hyperthyroidism, autonomic dysreflexia, or certain pharmacological reactions, rather than chronic renal failure. In end-stage kidney disease, clients typically present with a sallow, pale, or "earthy" complexion due to chronic anemia and uremic pigment accumulation. Flushing is not a hallmark sign of the fluid and metabolic disturbances seen pre-dialysis. B. Peripheral edema: Clients with end-stage kidney disease experience a significant decline in glomerular filtration, leading to the retention of sodium and water. This fluid volume excess manifests as dependent pitting edema in the lower extremities or sacral area. Pre-dialysis assessments frequently reveal this swelling as the body is unable to maintain fluid homeostasis. C. Diaphoresis: Excessive sweating is more indicative of hypoglycemia, myocardial infarction, or acute anxiety rather than the typical presentation of uremia. Clients waiting for dialysis are more likely to exhibit dry, itchy skin, known as uremic pruritus, caused by calcium-phosphate deposits. Diaphoresis is not a standard finding associated with the accumulation of nitrogenous wastes. D. Hypotension: Hypotension in renal patients is more commonly an intra-dialytic complication caused by rapid fluid removal or a side effect of antihypertensive therapy. Before dialysis, these clients usually exhibit hypertension due to the systemic effects of hypervolemia and the activation of the renin-angiotensin-aldosterone system. Low blood pressure is inconsistent with the typical pre-treatment fluid-overloaded state.