A client who has acute glomerulonephritis is hospitalized with acute kidney injury (AKI) and hyperkalemia. Which information will the nurse obtain to evaluate the effectiveness of the prescribed calcium gluconate IV?
Phosphate level
Cardiac rhythm
Urine output
Calcium level
The Correct Answer is B
A. Phosphate level: Phosphate levels are not directly affected by calcium gluconate administration. Monitoring phosphate is important in kidney disease but does not indicate the immediate effectiveness of calcium gluconate in hyperkalemia.
B. Cardiac rhythm: Calcium gluconate stabilizes cardiac membranes in hyperkalemia but does not lower potassium levels. Monitoring the cardiac rhythm allows the nurse to evaluate whether the medication is preventing life-threatening arrhythmias. This is the primary indicator of effectiveness.
C. Urine output: Urine output reflects kidney function but does not provide immediate information about the cardiac protective effects of calcium gluconate. Changes in urine are unrelated to the acute response to this therapy.
D. Calcium level: While calcium levels may increase slightly, the goal of IV calcium gluconate is membrane stabilization, not correcting hypocalcemia. Monitoring cardiac rhythm is more critical than measuring calcium levels to assess effectiveness.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Calculation:
- Calculate the Total 24-Hour Fluid Volume
The Parkland formula is: Total Volume = 4 mL × Weight (kg) × % TBSA burned
Weight: 72 kg
% TBSA Burned: 60%
Total Volume = 4 × 72 × 60
= 17,280 mL
- Calculate the Volume to be Infused in the First 8 Hours
Half of the total 24-hour volume is given in the first 8 hours.
Volume for 8 hours = Total Volume ÷ 2
= 17,280 ÷ 2
= 8,640 mL
- Calculate the Infusion Rate for the First 8 Hours
Flow Rate = Volume for 8 hours ÷ 8 hours
= 8,640 ÷ 8
= 1,080 mL/hr
Correct Answer is C
Explanation
A. The client denies nausea or anorexia: While improved appetite is beneficial, it does not directly indicate that lactulose is effective. Lactulose is primarily used to reduce ammonia levels and prevent hepatic encephalopathy. Symptom relief alone does not confirm therapeutic effect.
B. The client's bilirubin level decreases: Lactulose does not directly affect bilirubin levels. Bilirubin reflects liver excretory function, not the medication’s action on ammonia. Changes in bilirubin are not a reliable measure of lactulose effectiveness.
C. The client is alert and oriented: Lactulose reduces blood ammonia by promoting its excretion via the gastrointestinal tract. Improved mental status, such as being alert and oriented, indicates effective reduction of ammonia and prevention of hepatic encephalopathy.
D. The client has at least one stool daily: While increased bowel movements are expected with lactulose, the frequency alone does not confirm that ammonia levels are adequately reduced. Stool output is a mechanism, not the ultimate therapeutic outcome.
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