A nurse is reviewing the EKG strip of a client who has End Stage Renal Disease (ESRD) and has missed hemodialysis. Which of the following abnormalities on the client's EKG should the nurse interpret as a sign of hyperkalemia?

Prolonged P-R interval

Peaked T waves

Elevated ST segment

Inverted P wave

Answer and Explanation

The Correct Answer is B

A. Prolonged P-R interval: A prolonged P-R interval may indicate an atrioventricular (AV) block or conduction delay, but it is not specifically associated with hyperkalemia.

B. Peaked T waves: Peaked T waves are a classic EKG finding in hyperkalemia. Hyperkalemia can affect cardiac repolarization, leading to tall, peaked T waves on the EKG.

C. Elevated ST segment: An elevated ST segment may indicate myocardial injury or ischemia but is not typically associated with hyperkalemia.

D. Inverted P wave: An inverted P wave may indicate atrial enlargement or conduction abnormalities but is not specifically associated with hyperkalemia.

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Correct Answer is C

Explanation

A. A diet high in potassium: A high-potassium diet can actually help lower blood pressure and is often recommended for hypertensive patients.

B. Taking benazepril: Benazepril is an ACE inhibitor used to treat hypertension, so it is not a risk factor for developing high blood pressure.

C. Obstructive sleep apnea (OSA): OSA is a significant risk factor for the development of hypertension. The repeated episodes of apnea during sleep can lead to increased sympathetic nervous system activity and elevated blood pressure.

D. High-density lipoprotein (HDL) level of 70 mg/dL: A high HDL level is generally considered protective against cardiovascular diseases, including hypertension.

A. Assist with passive range of motion exercises. B. Monitor the pulse oximetry every two hours. C. Encourage 1 liter of fluid intake in 24 hours. D. Encourage the client to focus efforts on discharge.

Correct Answer is B

Explanation

A. Assist with passive range of motion exercises: While promoting mobility is important for overall well-being, it may not be the priority in a client with Pneumocystis jirovecii pneumonia, which requires respiratory support and oxygenation.

B. Monitor the pulse oximetry every two hours: Monitoring oxygen saturation is crucial in clients with Pneumocystis jirovecii pneumonia to assess respiratory status and the effectiveness of treatment. Hypoxemia is a common complication and requires prompt intervention.

C. Encourage 1 liter of fluid intake in 24 hours: Encouraging adequate fluid intake is important for hydration, but it may not be the priority over monitoring respiratory status in a client with pneumonia.

D. Encourage the client to focus efforts on discharge: Discharge planning is important but should not take precedence over immediate nursing care priorities such as respiratory assessment and monitoring.

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A nurse is reviewing the EKG strip of a client who has End Stage Renal Disease (ESRD) and has missed hemodialysis. Which of the following abnormalities on the client's EKG should the nurse interpret as a sign of hyperkalemia?

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