A nurse is reviewing the medical record of a client and identifies a serum potassium 6.8 mEq/L (3.5-5 mEq/L). Which of the following medications should the nurse expect to administer?
Lactulose
Acetylcysteine
Sodium polystyrene (Kayexalate)
Triamterene
The Correct Answer is C
A. Lactulose: Lactulose is used to treat hepatic encephalopathy by reducing ammonia levels, not for hyperkalemia.
B. Acetylcysteine: Acetylcysteine is used for acetaminophen overdose or as a mucolytic agent, not for hyperkalemia.
C. Sodium polystyrene (Kayexalate): Kayexalate is used to treat hyperkalemia by exchanging sodium for potassium in the intestines, promoting the elimination of potassium through the stool. This is the correct treatment for a potassium level of 6.8 mEq/L, which is dangerously high.
D. Triamterene: Triamterene is a potassium-sparing diuretic and would worsen hyperkalemia, not treat it.
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Related Questions
Correct Answer is B
Explanation
A. Dextrose 10% in water: Dextrose solutions provide calories but do not restore volume or replace electrolytes. They are not typically used in hypovolemic shock.
B. Lactated Ringer's: Lactated Ringer’s solution is an isotonic solution containing sodium, potassium, calcium, and lactate, which helps restore both fluid volume and electrolytes in the case of hypovolemic shock. It is commonly used while awaiting blood transfusions.
C. 0.33% sodium chloride: This is a hypotonic solution that can cause fluid to shift into cells and is not appropriate for fluid resuscitation in hypovolemia, which requires an isotonic solution.
D. 0.45% sodium chloride: This is a hypotonic solution as well, and it could worsen hypotension by causing fluid shifts into the cells, which is not ideal for treating hypovolemic shock.
Correct Answer is C
Explanation
A. Have the laboratory draw a blood sample for an erythrocyte sedimentation rate (ESR): ESR measures inflammation and is unrelated to hyperkalemia.
B. Restrict fluid intake: Fluid restriction is not appropriate for hyperkalemia unless specifically related to fluid overload or renal failure.
C. Obtain a 12-lead ECG: Hyperkalemia can cause life-threatening cardiac dysrhythmias such as peaked T waves, widened QRS complexes, or asystole. ECG monitoring is essential.
D. Administer potassium gluconate 40 mEq orally: This would worsen hyperkalemia and is contraindicated.
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