A patient with chronic renal failure has an occluded arteriovenous fistula, and routine hemodialysis is delayed. However, the patient's serum potassium level is 6.0 mEq/L. What should the nurse expect to be prescribed for this patient? Select all that apply.

Sodium bicarbonate.

Dextrose 10%.

Sodium polystyrene sulfonate (Kayexalate).

Insulin.

Answer and Explanation

Correct Answer : A,C,D

A, C, and D.

Choice A rationale:

The administration of sodium bicarbonate helps to correct acidosis, which can occur in chronic renal failure due to the accumulation of metabolic waste products in the absence of effective kidney function.

Choice C rationale:

Sodium polystyrene sulfonate (Kayexalate) is used to treat hyperkalemia, which is common in chronic renal failure due to impaired potassium excretion by the kidneys.

Choice D rationale:

Insulin can be prescribed to treat hyperkalemia by promoting the uptake of potassium into cells, thereby reducing the serum potassium level. Choice B and E rationale: Dextrose 10% and furosemide (Lasix) are not appropriate treatments for hyperkalemia. Dextrose 10% is a sugar solution and does not impact potassium levels, while furosemide is a loop diuretic that primarily affects sodium and water excretion, not potassium.

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Correct Answer is C

Explanation

Choice A rationale:

Hypocalcemia refers to low levels of calcium in the blood, which can present with symptoms like muscle cramps, numbness, and tingling. However, this choice is not relevant to the patient's symptoms in the scenario.

Choice B rationale:

Hypercalcemia is an electrolyte imbalance characterized by high levels of calcium in the blood. It can lead to ECG changes and symptoms like muscle weakness, confusion, and constipation. However, this is not the correct answer in the given scenario.

Choice C rationale:

The patient's symptoms of ECG changes and muscle weakness are consistent with hyperkalemia. Spironolactone is a potassium-sparing diuretic, and its use can lead to increased potassium levels in the blood (hyperkalemia), which can affect the heart's electrical activity and cause muscle weakness.

Choice D rationale:

Hypokalemia is a condition where there is a low level of potassium in the blood. It can lead to muscle weakness, ECG changes, and other symptoms, but it is not the correct answer in this specific situation involving spironolactone use.

A. Increased urine ketones. B. Decreased Hgb. C. Decreased urine specific gravity. D. Increased BUN.

Correct Answer is D

Explanation

Choice A rationale:

Increased urine ketones are not indicative of fluid volume deficit. Instead, they may suggest diabetic ketoacidosis or starvation ketosis.

Choice B rationale:

Decreased Hgb (hemoglobin) is not specific to fluid volume deficit and can be seen in various conditions such as anemia or bleeding.

Choice C rationale:

Decreased urine specific gravity is not consistent with fluid volume deficit, as it usually results in concentrated urine with increased specific gravity.

Choice D rationale:

An increased blood urea nitrogen (BUN) level is expected in fluid volume deficit due to reduced kidney perfusion and function. BUN is a marker of kidney function and is elevated when fluid volume is low.

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A patient with chronic renal failure has an occluded arteriovenous fistula, and routine hemodialysis is delayed. However, the patient's serum potassium level is 6.0 mEq/L. What should the nurse expect to be prescribed for this patient? Select all that apply.

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A patient prescribed spironolactone is demonstrating ECG changes and complaining of muscle weakness. The nurse realizes this patient is exhibiting signs of which electrolyte imbalance?

Correct Answer is C

Explanation

A nurse is assessing a client who has fluid volume deficit. The nurse should expect which of the following findings?

Correct Answer is D

Explanation

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