The nurse is caring for a client diagnosed with acute renal failure and has a potassium level of 8.3 mEq/L. What collaborative intervention would be a priority for this client?
Prepare the client for dialysis.
Start an IV and run normal saline at 50m/hour.
Repeat the electrolyte values later in the day
Monitor urine output
The Correct Answer is A
A. Prepare the client for dialysis: A potassium level of 8.3 mEq/L is critically high (normal range: 3.5–5.3 mEq/L), putting the client at immediate risk for life-threatening cardiac arrhythmias (e.g., ventricular fibrillation). Emergency dialysis is needed to remove excess potassium if other interventions (e.g., insulin, calcium gluconate) fail.
B. Start an IV and run normal saline at 50mL/hour: Fluid administration alone does not lower potassium quickly enough in a life-threatening situation.
C. Repeat the electrolyte values later in the day: Delaying treatment would increase the risk of cardiac arrest.
D. Monitor urine output: Although important, monitoring alone does not treat the emergency. Clients with acute renal failure often have little to no urine output.
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Related Questions
Correct Answer is D
Explanation
A. Diphenhydramine: An antihistamine used for motion sickness, but not first-line for severe nausea and dehydration.
B. Famotidine: A histamine-2 blocker used for acid reflux, not nausea control.
C. Omeprazole: A proton pump inhibitor for acid suppression, not for nausea and vomiting.
D. Ondansetron: Ondansetron (Zofran) is a serotonin (5-HT3) receptor antagonist that is highly effective for nausea and vomiting, especially in dehydration and severe vomiting.
Correct Answer is A
Explanation
A. Place the client on seizure precautions: Metabolic alkalosis can cause neuromuscular excitability, increasing the risk of seizures.
B. Encourage the client to breathe slowly: Slow breathing retains CO₂, which worsens alkalosis. The body needs hypoventilation, but this cannot be forced.
C. Plan to administer sodium bicarbonate to the client: Sodium bicarbonate worsens alkalosis and is only used in metabolic acidosis, not alkalosis.
D. Have the client breathe into a paper bag: This is a treatment for respiratory alkalosis, not metabolic alkalosis.
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