A nurse is planning care for a client who has serum potassium of 6.0 mEq/L (Range: 3.5-5.0). Which actions should the nurse anticipate? Select all that apply

Initiate 0.33% sodium chloride IV bolus

Administration of an Ace inhibitor

Administration sodium polystyrene sulfate (kayexalate)

Place the client on a cardiac monitor

Administration of Calcium Gluconate

Answer and Explanation

Correct Answer : C,D,E

A. Initiate 0.33% sodium chloride IV bolus: This is inappropriate as it does not address hyperkalemia and may worsen fluid balance issues.

B. Administration of an ACE inhibitor: ACE inhibitors can increase potassium levels and are contraindicated in hyperkalemia.

C. Administration of sodium polystyrene sulfate (Kayexalate): This medication promotes potassium excretion through the gastrointestinal tract.

D. Place the client on a cardiac monitor: Hyperkalemia affects cardiac function, and continuous monitoring is necessary to detect arrhythmias.

E. Administration of calcium gluconate: Calcium gluconate helps stabilize the cardiac membrane, reducing the risk of arrhythmias from hyperkalemia.

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Correct Answer is D

Explanation

A. Weight gain is typically seen in the oliguric phase, not the diuresis phase. In the diuresis phase, the client is excreting excess fluid, leading to weight loss.

B. A creatinine level of 1.0 is within the normal range and would not be expected during the diuresis phase of acute kidney injury, when creatinine levels would still be elevated.

C. GFR of 100 mL/min is normal, but in acute kidney injury, the GFR would be decreased. A GFR above 90 mL/min would not be expected in the diuresis phase.

D. Weight loss is a key finding in the diuresis phase due to the loss of excess fluids as the kidneys begin to recover.

A. Temperature 36.1° C (97.0°F) B. Weight loss C. Hypertension D. Insomnia

Correct Answer is C

Explanation

A. Temperature 36.1° C (97.0°F): A low or normal temperature is not indicative of organ rejection. Fever (≥ 38°C / 100.4°F) is a more concerning sign and may suggest rejection or infection.

B. Weight loss: Rejection often leads to fluid retention, not weight loss. Clients may actually experience weight gain due to fluid overload.

C. Hypertension: Hypertension is a key indicator of acute kidney rejection due to inflammation and impaired kidney function, leading to fluid retention and increased blood pressure. Rejection can cause renal vascular resistance and reduced urine output, leading to fluid overload and elevated blood pressure.

D. Insomnia: Insomnia is not a direct symptom of rejection. It may be due to medications like corticosteroids (e.g., prednisone), anxiety, or post-transplant stress.

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A nurse is planning care for a client who has serum potassium of 6.0 mEq/L (Range: 3.5-5.0). Which actions should the nurse anticipate? Select all that apply

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Naxlex Comprehensive Predictor Exams

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Correct Answer is D

Explanation

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Explanation

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