A nurse is preparing to administer prescribed intravenous potassium replacement supplements to a client who has a potassium level of 2.5 mEq/L (normal range: 3.5 to 5 mEq/L). Which of the following actions should the nurse plan to include? (Select all that apply.)
Ensure that the client's urine output is at least 1 mL/kg/hour.
Educate the client regarding high-potassium food sources.
Cardiac monitoring during infusion.
Repeat blood serum potassium.
Ensure potassium infusion is prepared with 5% dextrose solution.
Correct Answer : B,C,D
Choice A rationale: Potassium is primarily excreted by the kidneys. While adequate renal function is necessary, the standard minimum urine output for adults is 30 mL/hour rather than 1 mL/kg/hour.
Choice B rationale: Low potassium levels (2.5 mEq/L) require long-term management. Educating the client on potassium-rich foods like bananas and potatoes helps prevent future depletion and supports overall electrolyte balance.
Choice C rationale: Severe hypokalemia and rapid IV replacement increase the risk of lethal cardiac dysrhythmias. Continuous ECG monitoring is vital to detect life-threatening changes in cardiac conduction and rhythm.
Choice D rationale: Following intravenous replacement, serum levels must be re-evaluated to confirm the effectiveness of the treatment and ensure the client does not develop iatrogenic hyperkalemia.
Choice E rationale: Dextrose stimulates insulin secretion, which causes an intracellular shift of potassium. This can lead to a further decrease in serum potassium levels, worsening the client's hypokalemia.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason: Specific gravity is typically increased in clients who have hypovolemia, not decreased, due to the concentration of urine as the body atempts to conserve water.
Choice B reason: Creatinine levels are indeed increased in clients who have acute kidney injury, reffecting decreased kidney function and filtration.
Choice C reason: Potassium levels are not necessarily increased in clients who have polyuria. Polyuria can be associated with a variety of conditions and does not directly indicate high potassium levels.
Choice D reason: BUN, or blood urea nitrogen, is typically increased in clients who have dehydration, not decreased, due to the concentration of blood solutes as the body conserves water.
Correct Answer is D
Explanation
Choice A rationale: Cantaloupe is high in potassium. Clients with acute kidney injury (AKI) have impaired potassium excretion, and consuming high-potassium foods increases the risk of hyperkalemia, which can lead to cardiac arrhythmias.
Choice B rationale: Baked potatoes contain significant potassium, especially in the skin. In AKI, potassium retention is dangerous, so this choice reflects poor understanding of dietary restrictions for renal safety.
Choice C rationale: Yogurt is rich in potassium and phosphorus. In AKI, both electrolytes may accumulate due to reduced renal clearance, making yogurt an inappropriate choice without close monitoring.
Choice D rationale: Pecans are low in potassium, making them a safer snack for clients with AKI. Choosing low-potassium foods demonstrates appropriate understanding of renal dietary management.
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