A nurse is preparing to give a client an infusion of packed red blood cells (PRBCS). The nurse is priming her administration IV tubing, the nurse primes one side of the Y tubing with the blood and the other should be which solution?

A) Isotonic solution: Isotonic solutions, such as 0.9% sodium chloride, are used to maintain fluid balance and are not ideal for treating hypernatremia. They do not correct the elevated sodium levels and might even contribute to fluid overload.

B) Total Parenteral Nutrition (TPN): TPN is a form of nutrition provided intravenously and is not specifically used to manage electrolyte imbalances like hypernatremia. It is used for clients who cannot eat or absorb nutrients through the gastrointestinal tract.

C) Hypertonic solution: Hypertonic solutions, such as 3% sodium chloride, are used to treat hyponatremia or other conditions requiring increased sodium concentration. They would exacerbate hypernatremia rather than treat it.

D) Hypotonic solution: Hypotonic solutions, such as 0.45% sodium chloride (half-normal saline) or dextrose 5% in water (D5W), are appropriate for treating hypernatremia. These solutions help dilute the excess sodium in the blood, reduce serum sodium levels, and facilitate a gradual correction of the imbalance.

A) Constipation: Elevated potassium levels (hyperkalemia) typically affect neuromuscular and cardiac function rather than gastrointestinal motility. Constipation is more commonly associated with conditions like hypokalemia or electrolyte imbalances affecting the gastrointestinal system.

B) Polyuria: Polyuria, or excessive urination, is not directly caused by hyperkalemia. It can occur due to conditions like diabetes mellitus or diabetes insipidus, or as a side effect of certain medications like diuretics. Hyperkalemia does not typically lead to increased urine output and may even lead to oliguria if severe renal impairment occurs.

C) EKG with a U wave: The presence of a U wave on an electrocardiogram (EKG) is typically associated with hypokalemia, not hyperkalemia. U waves are seen when potassium levels are low, reflecting delayed repolarization of the ventricles. In hyperkalemia, EKG changes more commonly include peaked T waves, prolonged PR interval, and widened QRS complexes.

D) Paresthesias of the extremities: Hyperkalemia can cause paresthesias, which are sensations of tingling or numbness, particularly in the extremities. This occurs due to the effect of elevated potassium levels on nerve and muscle function. As potassium is essential for maintaining normal neuromuscular function, deviations from normal levels can disrupt action potentials and lead to sensory disturbances like paresthesias.