The nurse assesses the integumentary system of a client with chronic renal failure. Which findings should the nurse associate with this disease history? Select all that apply.

Rationale: A. Ecchymosis is a common finding in clients with chronic renal failure. This occurs because kidney disease often leads to platelet dysfunction and impaired clotting, which makes clients more prone to bruising even with minor trauma. B. Yellow-gray complexion is associated with chronic renal failure due to the accumulation of urochromes and other waste products in the blood that the failing kidneys cannot excrete. This discoloration is a hallmark skin change in long-term kidney disease. C. Moist, clammy skin is not typically associated with chronic renal failure. This presentation is more characteristic of conditions involving shock, hypoglycemia, or sympathetic overactivity, and is not a standard finding in chronic kidney disease. D. Complaints of pruritus are common in chronic renal failure. The buildup of uremic toxins in the skin can cause severe itching, which is a frequent and distressing symptom for these clients. E. Purpura is also associated with chronic renal failure. Similar to ecchymosis, purpura results from platelet dysfunction and bleeding tendencies, making clients more prone to these small, reddish-purple skin lesions.