A patient who has acute glomerulonephritis is hospitalized with hyperkalemia. Which information will the nurse monitor to evaluate the effectiveness of the prescribed calcium gluconate IV?
Cardiac rhythm
Neurologic status
Urine volume
Calcium level
The Correct Answer is A
A. Cardiac rhythm: Calcium gluconate is administered in hyperkalemia primarily to stabilize cardiac membranes and prevent life-threatening dysrhythmias. Monitoring the cardiac rhythm allows the nurse to evaluate the immediate effectiveness of the medication in reducing the risk of arrhythmias caused by elevated potassium levels.
B. Neurologic status: While hyperkalemia can cause muscle weakness or paresthesia, calcium gluconate does not lower serum potassium levels and therefore has minimal direct impact on neurologic symptoms. Monitoring neurologic status is important but not the primary measure of effectiveness.
C. Urine volume: Calcium gluconate does not promote potassium excretion or diuresis. Monitoring urine output is essential for overall renal function assessment but does not reflect the immediate cardiac-protective effect of the drug.
D. Calcium level: Although calcium gluconate raises serum calcium temporarily, the dose given for hyperkalemia does not significantly alter laboratory calcium levels. The clinical focus is on cardiac membrane stabilization rather than correcting hypocalcemia.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. Asking the patient to empty the bladder completely and then collecting the next specimen is not specific enough for a clean-catch technique. This method does not reduce contamination from the urethral meatus or surrounding genital area.
B. Using povidone iodine is not recommended for routine clean-catch urine collection because it can irritate the urethral area and does not offer additional benefit over standard cleansing with mild soap and water or antiseptic wipes.
C. Cleaning the urethral area reduces contamination, and discarding the initial urine flushes out bacteria from the urethra. Collecting midstream urine ensures that the sample accurately reflects bladder contents for culture and sensitivity testing.
D. Catheterization is an invasive procedure and is reserved for patients who cannot provide a clean-catch specimen. Routine midstream collection is preferred to reduce infection risk and discomfort while still providing an uncontaminated sample.
Correct Answer is B
Explanation
A. Breast cancer survivor for 8 years: A history of cancer may be a concern, but most transplant programs require 2–5 years of remission before eligibility. Being cancer-free for 8 years would not be a contraindication.
B. Alcohol use disorder: Active substance abuse is a contraindication because it increases the risk of poor medication adherence, post-transplant complications, and graft failure. Patients must demonstrate sobriety before being considered.
C. 65-years of age: Older age alone is not a contraindication. Many transplant centers accept patients in their 60s and even 70s, as long as they are otherwise healthy and suitable candidates for surgery.
D. Pacemaker: The presence of a pacemaker is not a contraindication to transplantation. It is compatible with surgery and long-term management, provided cardiac function is stable.
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