A nurse is caring for a client who is receiving an intravenous potassium infusion and who has a urine output of 10 mL/hr and a blood urea nitrogen of 50 mg/dL (10 to 20 mg/dL). Which of the following actions should the nurse take?
Obtain a prescription for furosemide.
Prepare the client for a urine culture and sensitivity.
Discontinue the potassium infusion.
Perform a bladder scan.
The Correct Answer is C
A. Obtain a prescription for furosemide: Administering a diuretic like furosemide could worsen hypovolemia or kidney injury if the client is already oliguric. It is not the first action when potassium is accumulating due to impaired renal excretion.
B. Prepare the client for a urine culture and sensitivity: While a UTI could contribute to kidney dysfunction, the immediate concern is elevated potassium in the context of severely reduced urine output, making infection screening secondary.
C. Discontinue the potassium infusion: The client has oliguria and elevated BUN, indicating impaired renal function. Continuing potassium infusion could lead to hyperkalemia and life-threatening cardiac complications. Stopping the infusion is the priority action to prevent toxicity.
D. Perform a bladder scan: A bladder scan assesses for urinary retention, which could contribute to low urine output. However, the elevated BUN suggests intrinsic kidney impairment, making discontinuing potassium more urgent than assessing retention.
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Related Questions
Correct Answer is D
Explanation
A. Thyroid-stimulating hormone level: TSH levels are used to assess thyroid function and are not affected by vancomycin therapy. Monitoring TSH is unrelated to safe administration of this antibiotic.
B. Blood glucose level: Blood glucose monitoring is important for clients with diabetes or receiving medications that affect glucose, but it is not directly relevant to vancomycin dosing or toxicity.
C. Total iron-binding count: Total iron-binding capacity reflects iron status and is unrelated to vancomycin therapy. It does not influence dosing or safety considerations for this antibiotic.
D. BUN level: Vancomycin is nephrotoxic, and kidney function must be monitored to prevent accumulation and toxicity. Blood urea nitrogen (BUN) provides an indicator of renal function, and reviewing it prior to the next dose helps ensure safe administration.
Correct Answer is B
Explanation
A. Methadone: Methadone is an opioid agonist used for opioid dependence and pain management. It does not treat the symptoms of alcohol withdrawal and is not indicated in this scenario.
B. Chlordiazepoxide: Chlordiazepoxide is a benzodiazepine commonly used to manage acute alcohol withdrawal. It reduces agitation, tremors, and the risk of seizures by enhancing GABAergic activity in the central nervous system.
C. Varenicline: Varenicline is used to aid smoking cessation by acting on nicotinic receptors. It does not alleviate alcohol withdrawal symptoms and is not part of standard alcohol withdrawal management.
D. Buprenorphine: Buprenorphine is a partial opioid agonist used for opioid use disorder. It is not effective in treating alcohol withdrawal and does not address the associated neurological excitability or risk of seizures.
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