A nursing intervention for Hyperkalemia is?

Instruct the patient to eat a diet high in potassium

Monitor cardiac status

Administer Spironolactone

Administer an IV of 0.9% NS with potassium added

Answer and Explanation

The Correct Answer is B

A. Instruct the patient to eat a diet high in potassium: This would be inappropriate for a patient with hyperkalemia, as high potassium intake could worsen the condition. Hyperkalemia requires a reduction in potassium intake, not an increase.

B. Monitor cardiac status: Hyperkalemia can cause dangerous cardiac arrhythmias and other heart-related issues. Therefore, it is critical to monitor the cardiac status of a patient with hyperkalemia to detect any changes that could indicate a life-threatening condition, such as arrhythmias.

C. Administer Spironolactone: Spironolactone is a potassium-sparing diuretic, which can increase potassium levels. Administering it in the case of hyperkalemia could worsen the condition, making this an inappropriate intervention.

D. Administer an IV of 0.9% NS with potassium added: Administering an IV solution with added potassium would worsen hyperkalemia, as it would increase potassium levels further. In cases of hyperkalemia, it's important to avoid additional potassium administration.

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Correct Answer is ["A","B","D"]

Explanation

A. Never give KCI intramuscularly (IM) or as an IV bolus: Potassium chloride (KCl) should never be administered via IM injection or as an IV bolus. Both methods can cause severe irritation, tissue necrosis, and cardiac complications. Potassium should be given slowly and diluted to prevent these risks.

B. Always dilute potassium chloride in a large amount of IV solution: Potassium chloride must always be diluted when administered IV to prevent vein irritation and reduce the risk of hyperkalemia. It should be given in a large volume of fluid to ensure safe, slow infusion.

C. Never administer more than 40 mEq/L of IV potassium chloride (KCl) per hour: While the general recommendation is to limit the infusion rate to 10-20 mEq/hour for most patients, in certain situations, doses higher than 40 mEq/L per hour might be prescribed under close monitoring depending on the specific clinical situation.

D. Monitor the IV site frequently for early signs of infiltration, as potassium is caustic to the tissues: Potassium chloride is irritating to veins and tissues. If the IV infiltrates (leaks into the surrounding tissue), it can cause significant tissue damage, so frequent monitoring of the IV site is essential.

A. elevated serum calcium and potassium levels B. decreased serum calcium and potassium levels C. impaired acid-base balance D. bradycardia and cardiac dysrhythmias

Correct Answer is B

Explanation

A. Elevated serum calcium and potassium levels: Hypomagnesemia typically causes decreased calcium levels, not elevated. Additionally, while magnesium helps maintain potassium levels, hypomagnesemia can lead to a drop in potassium, not an elevation.

B. Decreased serum calcium and potassium levels: Hypomagnesemia often leads to low calcium levels due to decreased parathyroid hormone secretion and can cause hypokalemia due to impaired potassium uptake in the kidneys.

C. Impaired acid-base balance: Hypomagnesemia itself does not cause significant acid-base imbalance. It’s more likely to cause electrolyte disturbances especially calcium and potassium, which can lead to arrhythmias, acid-base imbalance is not the primary concern.

D. Bradycardia and cardiac dysrhythmias: While hypomagnesemia can indeed cause cardiac dysrhythmias, a common manifestation is tachycardia rapid heart rate and certain types of arrhythmias like Torsades de Pointes, rather than bradycardia.

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A nursing intervention for Hyperkalemia is?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

When administering potassium chloride, which of following safety precautions must be observed? (Select all that apply)

Correct Answer is ["A","B","D"]

Explanation

Correct Answer is B

Explanation

A nurse is caring for four clients who have drainage tubes. The nurse should identify the client who has which of the following tubes as being at risk for hypokalemia?

The physician orders 500 mL of NS to infuse at 175 mL/h for a patient with vomiting. Tubing drop factor is 15 gtt/mL. Calculate the flow rate in drops per minute.

The nurse is teaching about the process of passively moving water from an area of lower particle concentration to an area of higher particle concentration. Which process is the nurse describing?

A nurse teaches a client who is at risk for mild hypernatremia. Which statement should the nurse include in this client's teaching?

The nurse is caring for a client with a critically high potassium level (Normal is 3.5-5.0 mEq/L). The client has received sodium polystyrene sulfonate (Kayexalate). The nurse determines the medication's effectiveness if the client's repeat serum potassium level is:

A client at risk for developing hyperkalemia states, "I love fruit and usually eat it every day, but now I can't because of my high potassium level." How should the nurse respond?

A patient presents to the emergency department with reports of vomiting and diarrhea for the past 48 hours. The health care provider orders isotonic intravenous (IV) therapy. Which IV will the nurse prepare?

The nurse is assessing a patient and finds crackles in the lung bases and neck vein distention. Which action will the nurse take first?