When administering medications to a group of clients, which client should the nurse closely monitor for development of acute kidney injury (AKI)?

Choice C reason: Sodium polystyrene sulfonate is a cation-exchange resin that binds to potassium in the intestine and removes it from the body through the stool. Sodium polystyrene sulfonate is used to treat hyperkalemia, or high potassium level, which can be caused by AKI, certain medications, or other conditions. Hyperkalemia can cause cardiac arrhythmias, muscle weakness, paralysis, or death. The normal range of potassium for adults is 3.5 to 5.0 mEq/L (3.5 to 5.0 mmol/L). Therefore, a decrease in potassium from above normal to within normal indicates that sodium polystyrene sulfonate has been effective in lowering potassium level and preventing complications. The nurse should monitor the client's serum potassium level regularly and adjust the dose of sodium polystyrene sulfonate as needed.

Choice A reason: Hemoglobin level of 13.5 g/dL (135 g/L) is not a laboratory finding that indicates that the medication has been effective, but rather a normal value that reflects the amount of oxygen-carrying protein in the blood. Hemoglobin is not affected by sodium polystyrene sulfonate or potassium level. The normal range of hemoglobin for adults is 12 to 16 g/dL (120 to 160 g/L). Therefore, a hemoglobin level of 13.5 g/dL does not indicate any change or improvement in the client's condition.

Choice B reason: Serum glucose level of 120 mg/dL (6.7 mmol/L) is not a laboratory finding that indicates that the medication has been effective, but rather a slightly elevated value that reflects the amount of sugar in the blood. Glucose is not affected by sodium polystyrene sulfonate or potassium level. The normal range of glucose for adults is 74 to 106 mg/dL (4.1 to 5.9 mmol/L). Therefore, a serum glucose level of 120 mg/dL may indicate impaired glucose metabolism or diabetes mellitus, but not the effectiveness of sodium polystyrene sulfonate.

Choice D reason: Serum ammonia level of 30 mg/dL (17.62 µmol/L) is not a laboratory finding that indicates that the medication has been effective, but rather a normal value that reflects the amount of nitrogen waste in the blood. Ammonia is not affected by sodium polystyrene sulfonate or potassium level. The normal range of ammonia for adults is 10 to 80 mg/dL (6 to 47 µmol/L). Therefore, a serum ammonia level of 30 mg/dL does not indicate any change or improvement in the client's condition.

Choice A reason: A cool, humidified air is not relevant for this client, as it does not affect the eyes or vision. A cool, humidified air may be beneficial for clients with respiratory conditions, such as asthma or bronchitis.

Choice B reason: A quiet, restful environment is not specific for this client, as it does not address the effects of mydriatic medication on the eyes or vision. A quiet, restful environment may be helpful for clients with stress, anxiety, or insomnia.

Choice C reason: A dimly lit room is the best environment for this client, as it reduces the glare and discomfort caused by mydriatic medication. Mydriatic medication is a type of eye drop that dilates the pupils and prevents them from constricting in response to light. This can improve the examination of the retina and optic nerve, but it also makes the eyes more sensitive to light and reduces the ability to focus on near objects.

Choice D reason: A warm room temperature is not necessary for this client, as it does not affect the eyes or vision. A warm room temperature may be comfortable for clients with cold intolerance, such as hypothyroidism or Raynaud's phenomenon.