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)

Answer and Explanation

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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Correct Answer is ["B","E"]

Explanation

A. Total bedrest is generally not recommended. It is important to balance rest with gentle movement to maintain joint function and prevent stiffness. Instead of complete bedrest, promoting periods of rest

while allowing for limited activity as tolerated is more appropriate. Avoiding use of affected joints may be beneficial during acute inflammation but complete immobilization can lead to muscle atrophy and joint stiffness.
B. Applying warm compresses to affected joints can help relieve stiffness and pain associated with RA. Warmth can improve blood flow and reduce muscle tension around the joints. This intervention is typically beneficial during periods of stiffness and can help increase comfort. However, cold compresses may also be used during acute inflammation to reduce swelling.
C. Placing pillows to keep the neck in a flexed position is not advisable for RA patients. It can cause discomfort and potentially worsen joint and muscle issues. Proper positioning should support natural body alignment, and patients should be encouraged to maintain a neutral neck position to avoid additional strain.
D. Continuous cardiac monitoring is not a routine intervention for RA exacerbations unless there is an indication of cardiac involvement or complications. RA itself does not typically require continuous cardiac monitoring.
E. Methylprednisolone is a corticosteroid used to reduce inflammation and manage RA symptoms during flares. Administering it as ordered is an appropriate intervention to control inflammation and alleviate symptoms.

A. Loss of central vision and distortion of lines B. Floaters and flashes of light C. Cloudy vision and glaring of lights D. Loss of peripheral vision

Correct Answer is A

Explanation

A. AMD affects the macula, which is responsible for central vision and fine detail. As the condition progresses, patients often experience a gradual loss of central vision, which can make it difficult to read, recognize faces, and perform tasks that require sharp vision. Distortion of straight lines (metamorphopsia) is also common, where straight lines may appear wavy or bent.
B. Floaters and flashes of light are more commonly associated with conditions affecting the vitreous body of the eye or retinal detachment, rather than AMD. These symptoms can occur due to changes in the vitreous gel or as a result of other retinal issues, but they are not the primary symptoms of AMD.
C. Cloudy vision and glare are typically associated with cataracts, not AMD. Cataracts cause the lens of the eye to become cloudy, leading to blurred vision and increased sensitivity to glare. AMD does not cause the lens to cloud, so these symptoms are not characteristic of AMD.
D. Loss of peripheral vision is more characteristic of glaucoma rather than AMD. AMD primarily affects central vision, leaving peripheral vision relatively intact until the disease progresses to an advanced stage. Glaucoma, on the other hand, often leads to a gradual loss of peripheral vision.

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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?

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Explanation

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Correct Answer is A

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