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.)

Repeat blood serum potassium

Educate client regarding high-potassium food sources

Cardiac monitoring during infusion

Ensure that the client's urine output is at least 1 mL/kg/hour

Ensure potassium infusion is prepared with 5% dextrose solution

Answer and Explanation

Correct Answer : C,D

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.

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Correct Answer is C

Explanation

A. The excretion of calcium by the kidneys is related to electrolyte balance and bone health but does not directly contribute to hydrostatic pressure in the vasculature.
B. Osmotic pressure is the force exerted by solutes (such as plasma proteins) drawing water into the bloodstream, which opposes hydrostatic pressure. It does not directly contribute to hydrostatic pressure but rather counterbalances it.
C. Hydrostatic pressure is primarily generated by the force of the heart's contraction, which pushes blood through the arteries and capillaries. This pressure drives fluid out of the blood vessels into the surrounding tissues, a crucial process in nutrient and waste exchange.
D. Pressure applied by plasma proteins contributes to oncotic (colloid osmotic) pressure, not hydrostatic pressure. Oncotic pressure pulls fluid into the capillaries, opposing the outward force of hydrostatic pressure.

A. Osmoreceptors in the pituitary gland regulate the secretion of cortisol in response to changes in plasma osmolality. B. Osmoreceptors in the hypothalamus detect high plasma osmolality and stimulate the release of antidiuretic hormone (ADH), which enhances water reabsorption in the kidneys. C. Osmoreceptors in the kidneys monitor blood pressure changes and regulate aldosterone secretion to control sodium reabsorption and water balance. D. Osmoreceptors in the hypothalamus detect low plasma osmolality and inhibit the release of antidiuretic hormone (ADH), leading to increased urine production.

Correct Answer is B

Explanation

A. Osmoreceptors in the pituitary gland regulate the secretion of cortisol in response to changes in plasma osmolality: This is incorrect as the pituitary gland itself does not have osmoreceptors; rather, the hypothalamus contains osmoreceptors.

B. Osmoreceptors in the hypothalamus detect high plasma osmolality and stimulate the release of antidiuretic hormone (ADH), which enhances water reabsorption in the kidneys: This is correct. Osmoreceptors in the hypothalamus sense changes in plasma osmolality and regulate ADH release to maintain water balance.

C. Osmoreceptors in the kidneys monitor blood pressure changes and regulate aldosterone secretion to control sodium reabsorption and water balance: This is not correct because the kidneys primarily use juxtaglomerular cells to sense blood pressure changes and regulate aldosterone, not osmoreceptors.

D. Osmoreceptors in the hypothalamus detect low plasma osmolality and inhibit the release of antidiuretic hormone (ADH), leading to increased urine production: This is partially correct; osmoreceptors do detect low osmolality, but their inhibition of ADH would decrease urine production, not increase it.

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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.)

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Correct Answer is B

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