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 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.

A. The client who has end-stage renal failure and is scheduled for dialysis today. B. The client who has been NPO since midnight for endoscopy. C. The client who has left-sided heart failure and has a brain natriuretic peptide (BNP) level of 600 pg/mL. D. The client who has gastroenteritis and is febrile.

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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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.

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Naxlex Comprehensive Predictor Exams

Correct Answer is B

Explanation

A nurse is caring for four hospitalized clients. Which of the following clients should the nurse identify as being at risk for fluid volume deficit?

Correct Answer is D

Explanation

A patient with a history of stomach ulcers is diagnosed with hypophosphatemia. What intervention should the nurse include in this patient's plan of care?

A nurse is reviewing a client's laboratory values and discovers the client has a serum potassium of 6.2 mEq/L. Which of the following interventions should the nurse anticipate?

A patient with fluid overload is prescribed furosemide (Lasix) 20 mg by mouth each day. What should the nurse include when teaching the patient about this medication? Select all that apply.

A nurse is caring for a client who is receiving IV fluids to correct dehydration. Which of the following laboratory values should indicate to the nurse that the client is effectively responding to treatment?

The nurse is reviewing the health problems for a group of assigned patients. Which patient does the nurse recognize as being at increased risk for developing metabolic alkalosis?

A patient experiencing multisystem fluid volume deficit has tachycardia, pale, cool skin, and decreased urine output. The nurse realizes these findings are most likely a direct result of which process?

A nurse is planning to teach a client about a high-potassium diet. Which of the following foods should the nurse instruct the client to eat? (Select all that apply.).