A nurse is collecting data on a patient who has chronic kidney disease.
Which finding is a sign of hyperkalemia?

Choice A rationale:

Metabolic alkalosis is an acid-base imbalance characterized by excessive loss of acid or excessive gain of bicarbonate produced by an underlying pathologic disorder. It causes metabolic, respiratory, and renal responses, producing characteristic symptoms. One of the manifestations of metabolic alkalosis is cardiovascular abnormalities, such as atrial tachycardia. Therefore, placing the patient on continuous cardiac monitoring is a necessary action to assess the patient’s heart rate and rhythm and detect any abnormalities early.

Choice B rationale:

Insulin is not typically used in the treatment of metabolic alkalosis. Insulin is a hormone that regulates blood sugar levels. It’s not directly related to the body’s acid-base balance. Therefore, obtaining a prescription for insulin for the patient would not be a relevant action in this case.

Choice C rationale:

Administering sodium bicarbonate to a patient with metabolic alkalosis would not be appropriate. Sodium bicarbonate is a base and is often used to treat metabolic acidosis, a condition characterized by an excess of acid in the body. Giving sodium bicarbonate to a patient with metabolic alkalosis, a condition characterized by an excess of base in the body, could potentially worsen the patient’s condition.

Choice D rationale:

Having the patient breathe into a paper bag is a common treatment for respiratory alkalosis, not metabolic alkalosis.

Respiratory alkalosis is caused by hyperventilation, which leads to a decrease in carbon dioxide in the blood. Breathing into a paper bag helps to increase the amount of carbon dioxide the person inhales, helping to restore the acid-base balance. However, metabolic alkalosis is not caused by hyperventilation, so this treatment

Choice A rationale:

The stool guaiac test does not check for bacteria in the feces. This test is used to detect hidden (occult) blood in a stool sample. It is the most common type of fecal occult blood test (FOBT)1.

Choice B rationale:

The stool guaiac test does not check for fat in the feces. The presence of fat in the feces is usually checked by a different test called a fecal fat test. The stool guaiac test is specifically designed to detect the presence of hidden blood in the stool.

Choice C rationale:

The stool guaiac test does not check for parasites in the feces. Parasites are typically detected using a stool ova and parasites (O&P) test. The stool guaiac test is used to detect hidden blood in the stool, which could be an indication of various conditions, including colon cancer or polyps in the colon or rectum.

Choice D rationale:

The stool guaiac test checks for hidden blood in the feces. This is the correct answer. The test can find blood even if you cannot see it yourself. Occult blood in the stool may indicate colon cancer or polyps in the colon or rectum, though not all cancers or polyps bleed. If blood is detected through a fecal occult blood test, additional tests may be needed to determine the source of the bleeding. The stool guaiac test can only detect the presence or absence of blood — it can’t determine what’s causing the bleeding.