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 A
Explanation
A. Hematocrit measures the proportion of blood volume that is occupied by red blood cells. Epoetin alfa stimulates red blood cell production, so a therapeutic effect would be indicated by an increase in hematocrit levels. This is a key laboratory result to monitor when assessing the effectiveness of epoetin alfa in treating anemia in CKD patients.
B. Serum potassium levels are important to monitor in CKD patients due to the risk of hyperkalemia, but they are not directly affected by epoetin alfa. Decreasing serum potassium is not a primary indicator of the therapeutic effect of epoetin alfa.
C. Platelet count measures the number of platelets in the blood, which are crucial for blood clotting. Epoetin alfa is not designed to affect platelet counts; thus, a change in platelet count is not an indicator of the medication's therapeutic effect.
D. White blood cell count reflects the immune system's status and is not directly influenced by epoetin alfa. This medication specifically targets red blood cell production and does not impact white blood cell counts.
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.
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