A nurse is assessing a client who is experiencing acute kidney injury. The client is found to have a significant change in mental status, is lethargic, and confused. The nurse auscultates crackles in the client's lungs. Upon reviewing labs, it is noted that the client's BUN is 140 mg/dL and the potassium is 6.7 mEq/L. Which treatment will the nurse anticipate to be ordered for a client with these findings?
Sodium polystyrene sulfonate (Kayexalate)
Bolus with 1 liter of lactated ringer's (LR)
Renal replacement therapy (RRT)
Patiromer (Veltassa)
The Correct Answer is C
A. While this medication is used to treat hyperkalemia, it is a slower acting treatment. Given the patient's critical condition with altered mental status, hyperkalemia, and elevated BUN, a more rapid intervention is needed.
B. Fluid resuscitation is important in some cases of AKI but it is not the priority in this patient. The patient is already showing signs of fluid overload (crackles in the lungs) and the primary issue is the inability of the kidneys to remove waste products and excess fluids.
C. This is the most appropriate treatment for this patient. RRT, such as hemodialysis or continuous renal replacement therapy (CRRT), can rapidly remove waste products, excess fluid, and electrolytes from the blood, correcting the imbalances and improving the patient's condition.
D. This medication is used for long-term management of hyperkalemia, but it is not effective in an acute setting like this.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. These values are within normal ranges.
B. BUN is low, but potassium and creatinine are within normal ranges.
C. Elevated potassium (hyperkalemia), low hemoglobin (anemia), and elevated creatinine are all classic signs of chronic kidney disease.
D. BUN and creatinine are slightly elevated, but not to a level indicative of chronic kidney disease. Potassium is within normal range.
Correct Answer is ["C","D"]
Explanation
A. Green beans are relatively low in potassium compared to other foods. While they do contain potassium, it is not in particularly high amounts. Therefore, they are generally considered safe in moderate amounts for individuals with CKD, but should still be monitored as part of a potassium- restricted diet.
B. Apples are low in potassium compared to many other fruits. They can be a good option for those needing to restrict potassium intake.
C. A typical serving of orange juice can contain a significant amount of potassium, which can contribute to elevated potassium levels in CKD patients. It should be limited or avoided to manage potassium intake effectively.
D. Avocados are high in potassium. A single avocado contains a substantial amount of potassium, making it a food that should be limited or avoided in a potassium-restricted diet for individuals with CKD.
E. Onions are relatively low in potassium and can be used in moderation by individuals with CKD. They are not typically a major concern for potassium restriction.
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