The nurse evaluates a client's response to hemodialysis. Which finding indicates an expected outcome?

Hemodialysis is a renal replacement therapy used to remove metabolic waste and excess fluid. Evaluating its effectiveness requires applying knowledge of solute clearance and normal laboratory values to determine if the procedure successfully filtered toxins from the patient's blood. Choice A rationale The primary goal of hemodialysis is to remove nitrogenous waste products like urea. A decrease in Blood Urea Nitrogen (BUN) from elevated levels toward the normal range of 10 to 20 mg/dL indicates successful solute clearance. Choice B rationale Hemodialysis is designed to filter small solutes and water, not to significantly decrease the white blood cell count. A normal WBC count ranges from 5,000 to 10,000/mm. A decrease is not an expected or desired dialysis outcome. Choice C rationale Patients with renal failure often have low calcium. Hemodialysis typically uses a dialysate containing calcium to help normalize levels toward 9.0 to 10.5 mg/dL. A decrease in calcium is generally an adverse finding, not a therapeutic goal. Choice D rationale Hemodialysis does not aim to decrease red blood cell counts. Patients with chronic kidney disease often have anemia due to low erythropoietin. A decrease in RBCs would be an undesirable complication rather than a measure of effectiveness.