A nurse is assisting with preparations for administering intravenous potassium replacement supplements to a client who has a potassium level of 2.5 mEq/L. Which of the following actions should the nurse plan to include? (Select all that apply.)

Repeat blood serum potassium

Educate client regarding high-potassium food sources

Cardiac monitoring during infusion

Ensure that the client's urine output is at least 1 mL/kg/hour

Ensure potassium infusion is prepared with 5% dextrose solution

Answer and Explanation

Correct Answer : C,D

A. Repeat blood serum potassium: While it’s important to monitor potassium levels, the immediate priority when preparing to administer potassium is ensuring safe administration practices, not rechecking levels before initiating therapy.

B. Educate client regarding high-potassium food sources: Client education is important for long-term management but is not a priority when preparing for intravenous potassium replacement in an acute setting.

C. Cardiac monitoring during infusion: Potassium affects cardiac conduction, and rapid correction can lead to arrhythmias. Continuous cardiac monitoring is necessary to detect any life-threatening arrhythmias during the infusion.

D. Ensure that the client's urine output is at least 1 mL/kg/hour: Adequate urine output ensures that the kidneys are functioning and capable of excreting excess potassium, reducing the risk of hyperkalemia.

E. Ensure potassium infusion is prepared with 5% dextrose solution: Potassium should not be mixed with dextrose, as it can increase insulin release, causing potassium to shift into cells and worsen hypokalemia.

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Correct Answer is C

Explanation

A. Respiratory alkalosis: Respiratory alkalosis is more commonly associated with hyperventilation and is not directly linked to the physiological effects of a tension pneumothorax, where the primary concern is intrathoracic pressure changes.

B. Increased venous return: In tension pneumothorax, intrathoracic pressure increases significantly, compressing the great vessels and the heart, leading to decreased venous return, not an increase.

C. Decreased cardiac output: Tension pneumothorax causes a rise in intrathoracic pressure, which compresses the heart and great vessels, leading to decreased venous return and, consequently, reduced cardiac output. This is a critical finding and requires immediate intervention.

D. Dilated ventricles: Ventricular dilation is generally associated with chronic heart conditions, not acute issues like tension pneumothorax, where decreased filling pressures are more of a concern than dilation.

A. BNP promotes the synthesis of angiotensin II to enhance fluid retention and increase blood pressure. B. BNP increases heart rate and cardiac contractility to enhance cardiac output. C. BNP increases blood pressure by causing vasoconstriction and stimulating aldosterone release. D. BNP decreases blood pressure by causing vasodilation and promoting sodium and water excretion.

Correct Answer is D

Explanation

A. BNP does not promote the synthesis of angiotensin II; instead, it counteracts the effects of the renin-angiotensin-aldosterone system (RAAS) by reducing fluid retention and blood pressure, which is the opposite of what angiotensin II does.
B. BNP does not increase heart rate or cardiac contractility. Its role is primarily in reducing cardiac workload by lowering blood pressure and decreasing fluid volume.
C. BNP does not increase blood pressure; rather, it acts to decrease it by causing vasodilation and inhibiting the effects of aldosterone, which would otherwise increase blood pressure by promoting sodium and water retention.
D. BNP decreases blood pressure by causing vasodilation and promoting the excretion of sodium and water, which reduces blood volume and, consequently, lowers the blood pressure. This is its primary role in cardiovascular regulation, especially in response to heart failure.

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A nurse is assisting with preparations for administering intravenous potassium replacement supplements to a client who has a potassium level of 2.5 mEq/L. Which of the following actions should the nurse plan to include? (Select all that apply.)

Nursing Test Bank

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