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 ["4"]
Explanation
To administer a total daily dose of 200 mg of imipramine divided equally every 12 hours, the nurse would need to give two doses of 100 mg each. Since the available tablets are 25 mg each, four tablets would be required to make up a single dose of 100 mg.
Therefore, the nurse should administer four tablets every 12 hours to meet the prescribed daily dosage.
Correct Answer is D
Explanation
A. A prostate examination is typically performed for issues related to the prostate, such as benign prostatic hyperplasia or prostate cancer. It is not relevant to diagnosing or managing acute glomerulonephritis, which is related to kidney inflammation rather than prostate issues.
B. A blood glucose check is used to diagnose and manage diabetes. While diabetes can contribute to chronic kidney disease, it is not the primary test for diagnosing acute glomerulonephritis or identifying its most common cause.
C. Genetic testing is useful for diagnosing inherited conditions or genetic predispositions to diseases. However, acute glomerulonephritis is typically caused by an infection or an autoimmune reaction, and genetic testing is not the primary diagnostic tool for this condition.
D. Antistreptolysin-O (ASO) titers are tests used to detect antibodies produced in response to a streptococcal infection. Elevated ASO titers indicate a recent streptococcal infection, which is the most common cause of post-infectious acute glomerulonephritis.
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