A client with acute kidney injury has a serum potassium level of 7.0 mEq/L (7.0 mmol/L). The nurse would plan which actions as a priority? (Select all that apply)

Place the client on a cardiac monitor.

Notify the primary health care provider (PHCP).

Put the client on NPO (nothing by mouth) status except for ice chips.

Review the client’s medications to determine whether any contain or retain potassium.

Allow an extra 500 mL of intravenous fluid intake to dilute the electrolyte concentration.

Answer and Explanation

Correct Answer : A,B,D

Choice A reason: A potassium level of 7.0 mEq/L risks lethal arrhythmias, necessitating cardiac monitoring. This aligns with hyperkalemia management, making it a correct priority action the nurse would plan to ensure the client’s safety and detect cardiac changes promptly.

Choice B reason: Notifying the provider is critical for a potassium level of 7.0 mEq/L, as urgent interventions like insulin or dialysis may be needed. This aligns with acute care protocols, making it a correct priority action for the nurse to address hyperkalemia.

Choice C reason: NPO status with ice chips is unrelated to hyperkalemia management, which focuses on lowering potassium. Cardiac monitoring is a priority, making this incorrect, as it’s not relevant to the nurse’s urgent actions for a client with severe hyperkalemia.

Choice D reason: Reviewing medications identifies potassium-containing or retaining drugs, preventing further elevation of 7.0 mEq/L. This aligns with hyperkalemia treatment, making it a correct priority action the nurse would plan to manage the client’s electrolyte imbalance effectively.

Choice E reason: Extra IV fluids (500 mL) may dilute potassium but risk fluid overload in acute kidney injury. Notifying the provider is more urgent, making this incorrect, as it’s not a priority compared to the nurse’s focus on immediate hyperkalemia interventions.

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Correct Answer is B

Explanation

Choice A reason: Shortness of breath is a heart failure symptom, not a furosemide side effect, which causes diuresis. Lightheadedness from hypotension is common, making this incorrect, as it confuses disease symptoms with medication effects in the nurse’s monitoring plan for furosemide.

Choice B reason: Lightheadedness is a common furosemide adverse effect due to hypotension or electrolyte imbalances from diuresis. This aligns with pharmacological monitoring for heart failure treatment, making it the correct effect the nurse should plan to monitor in the client.

Choice C reason: Dry cough is associated with ACE inhibitors, not furosemide, a diuretic causing hypotension. Lightheadedness is a furosemide effect, making this incorrect, as it misattributes a side effect to the wrong medication in the nurse’s monitoring for heart failure treatment.

Choice D reason: Bitter taste is not a typical furosemide side effect; it’s more linked to medications like antibiotics. Lightheadedness is relevant, making this incorrect, as it does not reflect the expected adverse effects the nurse should monitor with furosemide administration.

A. Ensuring that the concentration is no greater than 1 mEq/10mL (mmol/10 mL) of solution. B. Checking IV access for blood return after the infusion. C. Pushing the drug as a bolus slowly over 5 minutes. D. Initiating the IV in a hand vein for rapid access. E. Keeping the client NPO during drug treatment. F. Using an IV controller to deliver the drug.

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

Explanation

Choice A reason: Potassium concentration should be 10-20 mEq/100mL, not 1 mEq/10mL, to avoid irritation. Using an IV controller is correct, making this incorrect, as it’s an unsafe dilution compared to the nurse’s best practices for safe parenteral potassium administration.

Choice B reason: Checking IV access for blood return post-infusion ensures the potassium was delivered correctly, preventing extravasation. This aligns with IV therapy safety, making it a correct best practice the nurse should follow when administering parenteral potassium to the client.

Choice C reason: Pushing potassium as a bolus is dangerous, risking cardiac arrhythmias; it must be infused slowly. IV controller use is correct, making this incorrect, as it’s unsafe compared to the nurse’s best practices for administering potassium to a hypokalemic client.

Choice D reason: Hand veins are unsuitable for potassium, which is irritating and requires larger veins. Checking blood return is correct, making this incorrect, as it risks complications compared to the nurse’s best practices for safe potassium administration in the client.

Choice E reason: Keeping the client NPO is unnecessary for potassium administration, which addresses hypokalemia, not digestion. IV controller use is correct, making this incorrect, as it’s irrelevant to the nurse’s best practices for delivering parenteral potassium safely to the client.

Choice F reason: Using an IV controller ensures a safe, steady infusion rate for potassium, preventing cardiac complications. This aligns with medication safety protocols, making it a correct best practice the nurse should employ when administering parenteral potassium to the hypokalemic client.

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A client with acute kidney injury has a serum potassium level of 7.0 mEq/L (7.0 mmol/L). The nurse would plan which actions as a priority? (Select all that apply)

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who is being treated for heart failure and has a prescription for furosemide. The nurse should plan to monitor for which of the following adverse effects of the medication?

Correct Answer is B

Explanation

Which actions are considered best practices for the nurse to use during the administration of parenteral potassium to a client with a serum potassium level of 1.9 mEq/L (mmol/L)? (Select all that apply)

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

Explanation

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