A client with acute renal failure develops severe hyperkalemia. What would the nurse anticipate to be used to treat this imbalance?
Select one:
Sodium polystyrene sulfonate (Kayexalate)
Furosemide
10% calcium gluconate IV
Dextrose with regular insulin IV
The Correct Answer is D
A. Sodium polystyrene sulfonate removes potassium via the GI tract, but acts slowly and is not used for severe or emergency hyperkalemia.
B. Furosemide is a loop diuretic that can help excrete potassium if kidney function allows, but it is not reliable in acute renal failure.
C. Calcium gluconate is used to stabilize the cardiac membrane, not to lower potassium levels. It prevents arrhythmias but doesn't remove potassium.
D. A combination of dextrose and regular insulin IV is commonly used in emergencies. Insulin drives potassium into the cells, rapidly lowering serum potassium levels, and dextrose prevents hypoglycemia from insulin administration.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. The client with an H/H of 12.8 and 38 has lab values within acceptable range for a dialysis patient, especially since anemia is common in this population. This client is stable and does not require immediate assessment.
B. The client who does not have a bruit or thrill in the fistula is the priority. A lack of bruit or thrill may indicate that the arteriovenous (AV) fistula is clotted or not functioning, which is a critical issue. This compromises the client's ability to receive dialysis and requires urgent evaluation.
C. The client who is complaining of fatigue and headache may be experiencing symptoms related to uremia or hypertension, but these are not immediately life-threatening and can be addressed after checking the fistula issue.
D. The client who is complaining of nausea might be experiencing symptoms of fluid overload or uremia, but again, this is less urgent than a potentially non-functioning dialysis access site.
Correct Answer is D
Explanation
A. Lorazepam is a benzodiazepine, and its effects are reversed with flumazenil, not naloxone.
B. Warfarin is an anticoagulant, and its antidote is vitamin K, not naloxone.
C. Valproic acid is an antiepileptic medication, and naloxone has no role in reversing its effects.
D. Fentanyl is a potent opioid analgesic, and naloxone (Narcan) is an opioid antagonist that reverses opioid-induced respiratory depression, sedation, and hypotension
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