A nurse is caring for a client who is to receive potassium replacement. The provider’s prescription reads, “Potassium chloride 30 mEq in 0.9% sodium chloride 100 mL IV over 30 min.” For which of the following reasons should the nurse clarify this prescription with the provider?
The potassium infusion rate is too rapid.
Another formulation of potassium should be given IV.
Potassium chloride should be diluted in dextrose 5% in water.
The client should be treated by giving potassium by IV bolus.
The Correct Answer is A
According to various guidelines12345, the recommended rate of intravenous potassium replacement is 10-20 mEq/h with continuous ECG monitoring. The maximum rate is 40 mEq/h in emergency situations. The prescription given by the provider exceeds this limit and could cause cardiac arrhythmias or hyperkalemia.
Choice B is wrong because potassium chloride is a common and appropriate formulation of potassium for intravenous administration.
Choice C is wrong because potassium chloride should not be diluted in dextrose 5% in water, as this could cause hyperglycemia or osmotic diuresis.
Choice D is wrong because potassium should never be given by IV bolus, as this could cause cardiac arrest or tissue necrosis.
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Related Questions
Correct Answer is D
Explanation
This is because a weight gain of 2.5 kg (5 Ib) in 2 days indicates a worsening of heart failure and fluid retention, which may require an adjustment of the diuretic dose or other medications.
The provider should be informed of this change as soon as possible to prevent further complications.
Choice A is wrong because teaching the client about foods low in sodium is not the first action the nurse should take.
While a low-sodium diet is important for heart failure patients, it is not an urgent intervention and it does not address the immediate problem of fluid overload.
Choice B is wrong because determining medication adherence by the client is not the first action the nurse should take.
While it is important to assess if the client is taking furosemide as prescribed, it is not an urgent intervention and it does not rule out other causes of fluid retention, such as renal impairment or disease progression.
Choice C is wrong because encouraging the client to dangle the legs while sitting in a chair is not the first action the nurse should take.
While this may help reduce edema in the lower extremities, it does not address the underlying cause of fluid overload and it may worsen pulmonary congestion by increasing venous return to the heart.
Correct Answer is B
Explanation
Carbamazepine is an anticonvulsant medication that is used to treat seizures and nerve pain. It works by reducing the activity of certain nerve cells in the brain.
Choice A is wrong because beclomethasone is a corticosteroid that is used to treat asthma and allergic rhinitis. It does not interact with carbamazepine.
Choice B is correct because the estrogen-progestin combination is a hormonal contraceptive that is used to prevent pregnancy and regulate menstrual cycles. It interacts with carbamazepine because carbamazepine can increase the breakdown of estrogen and progestin in the body, making them less effective. The nurse should instruct the client to use an alternative or additional method of birth control while taking carbamazepine.
Choice C is wrong because diphenhydramine is an antihistamine that is used to treat allergies, motion sickness, and insomnia. It does not interact with carbamazepine.
Choice D is wrong because the nicotine transdermal system is a nicotine replacement therapy that is used to help people quit smoking. It does not interact with carbamazepine.
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