A nurse cares for a patient who has a serum potassium of 7.5 mEq/L and is exhibiting cardiovascular changes. Which should the nurse implement first?

Provide a heart healthy low potassium diet

Prepare to administer sodium polystyrene sulfate 15g by mouth

Prepare the patient for hemodialysis treatment

Prepare to administer dextrose 20% and 10 units of regular insulin IV push

Answer and Explanation

The Correct Answer is D

A. Provide a heart-healthy low-potassium diet:

While a heart-healthy low-potassium diet is essential for managing chronic hyperkalemia and preventing future occurrences, it is not the first intervention to implement in a patient with a serum potassium level of 7.5 mEq/L and exhibiting cardiovascular changes. The effects of dietary changes on serum potassium levels are gradual and may take days to have a significant impact. In an acute situation like this, immediate interventions are needed to rapidly lower potassium levels and address the associated cardiovascular risks.

B. Prepare to administer sodium polystyrene sulfate 15g by mouth:

Sodium polystyrene sulfate is a medication used to exchange sodium for potassium in the gastrointestinal tract, effectively lowering serum potassium levels over hours to days. While it is a valid treatment for hyperkalemia, its onset of action is not immediate enough to address the urgent cardiovascular changes seen in severe hyperkalemia. Therefore, it is not the first-line intervention in this scenario.

C. Prepare the patient for hemodialysis treatment:

Hemodialysis is an effective method for rapidly lowering serum potassium levels in cases of severe hyperkalemia. However, it is a more invasive and time-consuming procedure that requires preparation, including vascular access and dialysis setup. It is typically reserved for situations where other interventions have failed or in patients with severe or refractory hyperkalemia. In the context of this scenario, where the patient has a serum potassium level of 7.5 mEq/L and is exhibiting cardiovascular changes, hemodialysis may be considered if initial interventions are not successful, but it is not the first action to implement.

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Correct Answer is C

Explanation

A. Prevents complications, such as meningitis or pneumonitis

While oral acyclovir can be effective in managing HSV infections and reducing the severity of symptoms, it is not primarily used to prevent complications such as meningitis or pneumonitis. These complications may occur in severe cases of HSV infections, but oral acyclovir's main goal is to manage outbreaks and reduce symptoms.

B. Decreases the probability of recurrent outbreaks

Oral acyclovir can help reduce the frequency of recurrent outbreaks in individuals with HSV infections. However, it does not completely eliminate the probability of recurrent outbreaks. Some individuals may still experience occasional outbreaks even with regular use of oral acyclovir. The medication is more focused on managing outbreaks when they occur rather than preventing them entirely.

C. Shortens the outbreak and lessens the severity of symptoms

This option is the correct choice. Oral acyclovir is effective in shortening the duration of HSV outbreaks and reducing the severity of symptoms such as pain, itching, and lesions. It works by inhibiting the replication of the virus, which helps in faster healing and symptom relief. However, it does not cure the infection or eliminate the virus from the body.

D. Eliminates the likelihood of spreading the infection to others

While oral acyclovir can help manage outbreaks and reduce viral shedding, it does not completely eliminate the risk of spreading the infection to others. It can reduce the likelihood of transmission during active outbreaks, but individuals with HSV can still shed the virus and be contagious even when they are not experiencing visible symptoms. Therefore, other precautions such as practicing safe sex and avoiding close contact during outbreaks are also important for preventing transmission.

A. Diarrhea and vomiting for 36 hours B. Chronic obstructive pulmonary disease (COPD) C. Anxiety-induced hyperventilation D. Diabetic ketoacidosis and chronic obstructive pulmonary disease (COPD)

Correct Answer is C

Explanation

A. Diarrhea and vomiting for 36 hours:

Diarrhea and vomiting can lead to metabolic acidosis due to loss of bicarbonate and increased hydrogen ion concentration in the blood. However, the ABG values provided indicate respiratory alkalosis (high pH and low PaCO2), which is not consistent with metabolic acidosis caused by diarrhea and vomiting. Therefore, this choice does not correlate with the ABG values.

B. Chronic obstructive pulmonary disease (COPD):

COPD is a respiratory condition characterized by airflow limitation and increased airway resistance. It can lead to respiratory acidosis due to retention of carbon dioxide (PaCO2 levels would be elevated). The ABG values in the scenario show respiratory alkalosis (low PaCO2), which is the opposite of what would be expected in COPD. Therefore, this choice does not correlate with the ABG values provided.

C. Anxiety-induced hyperventilation:

Anxiety-induced hyperventilation is a common cause of respiratory alkalosis. During hyperventilation, there is excessive elimination of carbon dioxide (PaCO2 levels decrease), leading to an increase in pH (alkalosis). The ABG values in the scenario show a high pH (7.48) and low PaCO2 (28 mm Hg), consistent with respiratory alkalosis seen in hyperventilation due to anxiety.

D. Diabetic ketoacidosis and chronic obstructive pulmonary disease (COPD):

Diabetic ketoacidosis (DKA) is a metabolic condition characterized by hyperglycemia, ketosis, and metabolic acidosis (low pH and low bicarbonate levels). COPD, as mentioned earlier, can lead to respiratory acidosis due to retained carbon dioxide. Neither of these conditions correlates with the ABG values provided, which show respiratory alkalosis (high pH and low PaCO2). Therefore, this choice does not correlate with the ABG values.

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A nurse cares for a patient who has a serum potassium of 7.5 mEq/L and is exhibiting cardiovascular changes. Which should the nurse implement first?

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Naxlex Comprehensive Predictor Exams

A patient is prescribed oral acyclovir for type 1 herpes simplex virus. What is the expected outcome if the patient is compliant with the medication regimen?

Correct Answer is C

Explanation

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Correct Answer is C

Explanation

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