A client is in the oliguric phase of acute kidney injury (AKI) which was caused by massive tissue trauma. The nurse notes peaked T-waves and a widened QRS complex on the cardiac monitor. What is the first action the nurse should take?
Check the client's most recent potassium level
Administer a bolus of 1,000 mL of normal saline
Administer potassium chloride intravenously (IV)
Administer sodium polystyrene sulfonate (Kayexalate)
The Correct Answer is A
A. Peaked T-waves and a widened QRS complex on an ECG are often signs of hyperkalemia, which is an elevated potassium level in the blood. This can be a serious complication of acute kidney injury (AKI), especially in the oliguric phase when the kidneys are unable to effectively excrete potassium.A
B. While fluid management is important in AKI, administering a bolus of normal saline is not the first priority in the presence of suspected hyperkalemia. The primary concern is to address the electrolyte imbalance.
C. Administering potassium chloride would worsen hyperkalemia and should be avoided.
D. Kayexalate is a medication used to treat hyperkalemia by exchanging sodium ions for potassium ions in the gastrointestinal tract. However, checking the potassium level is the first step in confirming the diagnosis and determining the appropriate treatment.
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Related Questions
Correct Answer is {"dropdown-group-1":"B","dropdown-group-2":"B"}
Explanation
Peritonitis
Peritonitis is an infection of the peritoneum (the lining of the abdominal cavity), often related to peritoneal dialysis. It can present with abdominal pain, fever, rigidity, and rebound tenderness,
consistent with the client’s symptoms. Cloudy effluent is also a common sign of peritoneal dialysis- related peritonitis.
Peritoneal dialysis
Peritoneal dialysis is a type of dialysis that uses the peritoneum (abdominal lining) to filter blood. If there is an issue with the dialysis process, it could lead to complications such as peritonitis. This is consistent with the client's symptoms, such as abdominal pain, fever, nausea, vomiting, and cloudy effluent.
Correct Answer is D
Explanation
A. While vitamin A can interact with some medications, it does not have a significant effect on verteporfin.
B. Verteporfin does not typically affect blood sugar levels.
C. Verteporfin is usually administered intravenously, so it is not taken orally.
D. Verteporfin is a photosensitizing agent used in photodynamic therapy for age-related macular degeneration. After treatment with verteporfin, the client should avoid sunlight and other intense light for several days to prevent a severe sunburn-like reaction. This is because verteporfin makes the skin and eyes more sensitive to light.
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