A nurse is caring for a client who has acute kidney injury and a potassium level of 6.5 mEq/L (3.5 to 5 mEq/L). Which of the following electrocardiogram (ECG) changes should the nurse expect?

Rationale:
A. Prominent P waves: Hyperkalemia typically causes a decrease in P wave amplitude and can eventually lead to their disappearance, rather than making them more prominent. Prominent P waves are not characteristic of elevated potassium levels.

B. Narrowed QRS complexes: Hyperkalemia often leads to a widening, not narrowing, of the QRS complex as potassium levels rise. A narrowed QRS complex is not a hallmark finding in clients with elevated potassium.

C. Shortened PR intervals: Hyperkalemia is more commonly associated with prolonged PR intervals. A shortened PR interval is not typically seen in potassium imbalance and would be more relevant in other conduction abnormalities.

D. Peaked T waves: Tall, peaked T waves are the classic early ECG finding in hyperkalemia. They result from increased potassium altering myocardial repolarization and are often the first electrocardiographic sign of elevated serum potassium.

Rationale:
A. Contact precautions: Contact precautions are used for infections spread by direct or indirect contact, such as Clostridioides difficile or MRSA. Tuberculosis is transmitted through airborne particles, not contact.

B. Protective environment precautions: Protective environments are for immunocompromised clients, such as those undergoing stem cell transplants, to protect them from external infections. This does not apply to clients with active infections like tuberculosis.

C. Droplet precautions: Droplet precautions are used for infections spread through large respiratory droplets, like influenza or pertussis. Tuberculosis is spread via much smaller airborne particles that remain suspended in the air.

D. Airborne precautions: Airborne precautions are required for tuberculosis because it is spread through tiny airborne droplets. These precautions include placing the client in a negative pressure room and having staff wear an N95 respirator when entering the room.