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.
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Hypernatremia.
Choice A rationale:
Hypernatremia is the most likely condition the client is experiencing based on the laboratory result of Sodium 144 mEq/L, which is above the normal range of 136 to 145 mEq/L. Hypernatremia is an elevated sodium level in the blood and can cause various symptoms like extreme thirst, dry mucous membranes, and altered mental status.
Choice B rationale:
To address hypernatremia, the nurse should take two actions. Action 1: Prepare to check a serum albumin level. This is important as hypernatremia can be caused by a relative water deficit due to excess solutes, and measuring serum albumin helps assess the body's water balance. Action 2: Request a STAT ECG. Hypernatremia can lead to cardiac arrhythmias, so an ECG is essential to monitor the patient's heart rhythm. Parameters to Monitor: Parameter 1 - Serum bicarbonate level: Monitoring bicarbonate levels helps evaluate acid-base balance and assess the impact of hypernatremia on the body's buffering systems. Parameter 2 - Intake and Output: Monitoring the patient's fluid intake and output is crucial to ensure proper hydration and track response to treatment.
Correct Answer is D
Explanation
The correct answer is choice D. The client who has gastroenteritis and is febrile.
Choice A rationale:
The client with end-stage renal failure scheduled for dialysis would not be at risk for fluid volume deficit because dialysis is a treatment that removes waste, salt, and extra water to prevent them from building up in the body, keeping a safe level of certain chemicals in the blood, and controlling blood pressure.
Choice B rationale:
Being NPO (nothing by mouth) since midnight for endoscopy typically involves a short period of fasting. While it could potentially contribute to a mild fluid volume deficit, it is not as significant as other causes like vomiting or diarrhea, which can lead to more substantial fluid losses.
Choice C rationale:
A client with left-sided heart failure and an elevated BNP level is more likely to experience fluid volume overload rather than a deficit. BNP is released in response to ventricular volume expansion and pressure overload, which are indicative of heart failure, not fluid volume deficit.
Choice D rationale:
The client with gastroenteritis and a fever is at risk for fluid volume deficit due to increased fluid losses from vomiting, diarrhea, and fever-induced perspiration. These symptoms align with the common risk factors for fluid volume deficit, which include vomiting, diarrhea, and sweating.
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