A nurse is assisting with preparations for administering intravenous potassium replacement supplements to a client who has a potassium level of 2.5 mEq/L. Which of the following actions should the nurse plan to include? (Select all that apply.)

A. Impaired carbon dioxide elimination due to shunting: Shunting in ARDS affects oxygenation rather than carbon dioxide elimination. ARDS primarily results in impaired gas exchange due to inflammation and fluid accumulation in the alveoli, affecting oxygen rather than CO2.

B. Decreased pulmonary arterial pressure due to ventilation-perfusion (V/Q) mismatch: ARDS typically leads to increased pulmonary arterial pressure due to inflammation and decreased lung compliance. The V/Q mismatch contributes to impaired gas exchange, often resulting in elevated pulmonary arterial pressure rather than decreased.

C. Hypoxemia due to dead space: In ARDS, hypoxemia is primarily due to impaired gas exchange from damaged alveoli, not due to dead space. Dead space refers to areas where ventilation occurs without adequate blood flow, which is not the main issue in ARDS.

D. Decreased pulmonary compliance due to stiffness: ARDS is characterized by decreased pulmonary compliance due to the stiffness of the lung tissue caused by inflammation and edema. This decreased compliance makes lung expansion more difficult, which is a central feature of ARDS.

A. Repeat blood serum potassium: While it’s important to monitor potassium levels, the immediate priority when preparing to administer potassium is ensuring safe administration practices, not rechecking levels before initiating therapy.

B. Educate client regarding high-potassium food sources: Client education is important for long-term management but is not a priority when preparing for intravenous potassium replacement in an acute setting.

C. Cardiac monitoring during infusion: Potassium affects cardiac conduction, and rapid correction can lead to arrhythmias. Continuous cardiac monitoring is necessary to detect any life-threatening arrhythmias during the infusion.

D. Ensure that the client's urine output is at least 1 mL/kg/hour: Adequate urine output ensures that the kidneys are functioning and capable of excreting excess potassium, reducing the risk of hyperkalemia.

E. Ensure potassium infusion is prepared with 5% dextrose solution: Potassium should not be mixed with dextrose, as it can increase insulin release, causing potassium to shift into cells and worsen hypokalemia.