The nurse reviews the client’s laboratory results and notes elevated blood urea nitrogen (BUN) and creatinine levels, along with possible electrolyte imbalances. Which question(s) should the nurse ask the client based on these findings? Select all that apply.

 

Choice A Reason:

Sodium polystyrene sulfonate is used to treat hyperkalemia (high potassium levels) by exchanging sodium ions for potassium ions in the intestines, which are then excreted in the stool. A serum potassium level of 3.8 mEq/L is within the normal range (3.5 to 5 mEq/L), indicating that the medication has effectively reduced the potassium level to a safe range. Monitoring potassium levels is crucial in clients with AKI to prevent complications such as cardiac arrhythmias.

Choice B Reason:

A hemoglobin level of 13.3 g/dL is slightly below the normal range for adults (14 to 18 g/dL for males and 12 to 16 g/dL for females). While it is important to monitor hemoglobin levels, this value does not directly indicate the effectiveness of sodium polystyrene sulfonate, which is specifically used to manage potassium levels.

Choice C Reason:

A serum ammonia level of 30 µg/dL is within the normal range (10 to 80 µg/dL). However, this value does not reflect the effectiveness of sodium polystyrene sulfonate, as the medication is not used to manage ammonia levels. Ammonia levels are more relevant in conditions affecting liver function, such as hepatic encephalopathy.

Choice D Reason:

A serum glucose level of 100 mg/dL is within the normal range (74 to 106 mg/dL). While it is important to monitor glucose levels, this value does not indicate the effectiveness of sodium polystyrene sulfonate. The medication’s primary function is to reduce potassium levels, not to manage glucose levels.

Choice A reason:

Asking if the client’s morning voids are dark-colored can help identify potential side effects of carbidopa-levodopa, such as darkened urine, which is a known but harmless side effect. However, this does not directly address the client’s concern about the medication’s effectiveness.

Choice B reason:

Evaluating the client for signs of dyskinesia is important because dyskinesia can be a side effect of long-term carbidopa-levodopa use. However, this step is more relevant after understanding the client’s specific concerns about the medication’s effectiveness.

Choice C reason:

Determining if the client is taking the medication before meals is crucial because food can affect the absorption of carbidopa-levodopa. Taking the medication on an empty stomach can enhance its effectiveness. However, this step should follow a more detailed exploration of the client’s concerns.

Choice D reason:

Exploring what the client means by the drug “is not working” is the most important first step. This allows the nurse to understand the client’s specific issues, whether they are related to symptom management, side effects, or other concerns. This information is essential for tailoring subsequent interventions and providing appropriate education and support.