A nurse is caring for a client who has a new arteriovenous (AV) graft in his left forearm. Which of the following techniques should the nurse use to assess the patency of this graft?

 

Choice A reason: The erythrocyte sedimentation rate (ESR) is not directly affected by epoetin alfa therapy, which is used to treat anemia.

Choice B reason: Epoetin alfa stimulates erythropoiesis, leading to an increase in red blood cell production, which would be reflected in an increased hematocrit level.

Choice C reason: The platelet count is not directly affected by epoetin alfa therapy.

Choice D reason: The leukocyte count is not directly affected by epoetin alfa therapy.

Choice A rationale: Potassium is primarily excreted by the kidneys. While adequate renal function is necessary, the standard minimum urine output for adults is 30 mL/hour rather than 1 mL/kg/hour.

Choice B rationale: Low potassium levels (2.5 mEq/L) require long-term management. Educating the client on potassium-rich foods like bananas and potatoes helps prevent future depletion and supports overall electrolyte balance.

Choice C rationale: Severe hypokalemia and rapid IV replacement increase the risk of lethal cardiac dysrhythmias. Continuous ECG monitoring is vital to detect life-threatening changes in cardiac conduction and rhythm.

Choice D rationale: Following intravenous replacement, serum levels must be re-evaluated to confirm the effectiveness of the treatment and ensure the client does not develop iatrogenic hyperkalemia.

Choice E rationale: Dextrose stimulates insulin secretion, which causes an intracellular shift of potassium. This can lead to a further decrease in serum potassium levels, worsening the client's hypokalemia.