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.

The correct answer is choice D: Reduction of T-wave amplitude.

Choice A rationale:

The amplitude of the QRS complex is not directly affected by changes in serum potassium levels. It represents ventricular depolarization, and its restoration would not be an expected outcome of polystyrene sulfonate treatment

Choice B rationale:

Shortening of the P-wave duration is not an expected change with polystyrene sulfonate treatment. The P-wave represents atrial depolarization, which is not significantly impacted by the administration of this medication

Choice C rationale:

Widening of the QRS complex is associated with high serum potassium levels. The goal of polystyrene sulfonate treatment is to lower potassium levels and, thus, return the QRS complex to its normal width

Choice D rationale:

Polystyrene sulfonate aims to reduce serum potassium levels. When effective, this should result in a reduction of T-wave amplitude, which is a common ECG change seen with hyperkalemia

In conclusion, choice D is the correct answer, as a reduction in T-wave amplitude would be the expected change on the client's ECG if polystyrene sulfonate effectively lowers their serum potassium level.

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.