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 A
Explanation
Choice A rationale:
The client with a phosphate level of 5.7 mg/dL likely has a manifestation of hypoparathyroidism. Hypoparathyroidism leads to decreased parathyroid hormone (PTH) secretion, which causes increased renal phosphate reabsorption, leading to elevated phosphate levels in the blood.
Choice B rationale:
A calcium level of 9.8 mg/dL is within the normal range (8.5-10.2 mg/dL) and does not indicate hypoparathyroidism.
Choice C rationale:
A vitamin D level of 25 ng/mL is within the normal range (30-100 ng/mL) and does not suggest hypoparathyroidism.
Choice D rationale:
A magnesium level of 1.8 mEq/L is within the normal range (1.7-2.2 mEq/L) and does not directly indicate hypoparathyroidism.
Correct Answer is B
Explanation
The correct answer is B. 600 milliliters.
Choice A rationale:
A 24-hour urine output of 1000 milliliters is within the normal range for an adult, indicating adequate kidney function and hydration.
Choice B rationale:
A 24-hour urine output of 600 milliliters is below the normal range (typically 800-2000 milliliters), which may indicate oliguria (reduced urine output) and could be a sign of renal impairment or dehydration. This warrants notifying the healthcare provider.
Choice C rationale:
A 24-hour urine output of 1200 milliliters is also within the normal range, suggesting normal kidney function and hydration status.
Choice D rationale:
A 24-hour urine output of 750 milliliters is slightly below the normal range but may not be immediately concerning unless accompanied by other symptoms. However, it is still important to monitor and possibly notify the healthcare provider if it persists.
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