The nurse is caring for a client who had a cholecystectomy two days ago. The client is febrile, reporting upper abdominal pain radiating to the back and has had three episodes of vomiting in the last 8 hours. The nurse reviews the client's serum amylase and lipase level results which are twice the normal value. Based on these findings, the nurse should recognize the client is exhibiting symptoms of which condition?

Choice A reason: Sodium polystyrene sulfonate is a medication that binds to excess potassium in the gastrointestinal tract and removes it from the body through feces. It is used to treat hyperkalemia, which is a high level of potassium in the blood. Hyperkalemia can cause cardiac arrhythmias and muscle weakness, and it is a common complication of AKI. Therefore, this medication should be administered first to lower the potassium level and prevent life-threatening complications.

Choice B reason: Sevelamer is a medication that binds to phosphorus in the gastrointestinal tract and removes it from the body through feces. It is used to treat hyperphosphatemia, which is a high level of phosphorus in the blood. Hyperphosphatemia can cause bone loss and soft tissue calcification, and it is a common complication of chronic kidney disease (CKD). However, it is not an urgent issue in AKI, and it does not affect the potassium level.

Choice C reason: Calcium acetate is a medication that also binds to phosphorus in the gastrointestinal tract and removes it from the body through feces. It has the same effect and indication as sevelamer, but it also provides calcium supplementation. However, it is not an urgent issue in AKI, and it does not affect the potassium level.

Choice D reason: Epoetin alfa, recombinant is a medication that stimulates the production of red blood cells in the bone marrow. It is used to treat anemia, which is a low level of hemoglobin or red blood cells in the blood. Anemia can cause fatigue, weakness, and shortness of breath, and it is a common complication of CKD and AKI. However, it is not an urgent issue in AKI, and it does not affect the potassium level.

Choice A reason: Place the client in a room near the elevator: This does **not** promote client safety, because it exposes the client to more noise and disturbance, which can increase stress and blood pressure. A quiet and calm environment is preferable for stroke clients.

Choice B reason: Complete a swallow study before giving anything by mouth: This **promotes** client safety, because it assesses the client's ability to swallow and prevent aspiration. Stroke clients may have impaired swallowing due to facial weakness or sensory loss.

Choice C reason: Provide a call button kept within reach: This **promotes** client safety, because it allows the client to communicate their needs and request assistance when needed. Stroke clients may have limited mobility or vision, which can increase their risk of falls or injuries.

Choice D reason: Initiate use of the bed alarm: This **promotes** client safety, because it alerts the staff if the client tries to get out of bed without assistance. Stroke clients may have impaired judgment or balance, which can lead to falls or accidents.

Choice E reason: Place client belongings out of reach: This does **not** promote client safety, because it makes the client feel frustrated and helpless. Stroke clients may have difficulty reaching for their belongings due to hemiparesis or hemiplegia, which can affect their self-care and independence. The nurse should place the client's belongings within reach on their unaffected side and encourage them to use them as much as possible.

Choice F reason: Instruct the client to call before getting up: This **promotes** client safety, because it ensures that the client has adequate support and supervision when getting up. Stroke clients may have orthostatic hypotension, which can cause dizziness or fainting when changing positions. The nurse should assist the client to get up slowly and monitor their vital signs.