During the diuretic phase of acute kidney injury, the nurse understands that the client is at risk for which of the following electrolyte imbalances?

Hyperkalemia and hypernatremia

Hypokalemia and hypernatremia

Hyperkalemia and hyponatremia

Hypokalemia and hyponatremia

Answer and Explanation

The Correct Answer is D

A.   Hyperkalemia and hypernatremia are generally not associated with the diuretic phase of AKI. In the diuretic phase, the primary issue is excessive loss of electrolytes and fluid, rather than their accumulation.
B.   Hypokalemia can occur during the diuretic phase because diuretics increase the excretion of potassium along with water. Hypernatremia is not typical of the diuretic phase. Instead, sodium levels might decrease or remain normal due to the loss of fluid and electrolytes.
C.   Hyperkalemia is unlikely during the diuretic phase as diuretics often lead to increased potassium loss. Hyponatremia is a more likely outcome during the diuretic phase due to the loss of sodium and fluid through increased urine output.

D.   During the diuretic phase of AKI, there is significant loss of electrolytes, including potassium and sodium. Diuretics increase urine output, leading to the loss of potassium and sodium, which can occur as a result of excessive fluid and electrolyte loss.

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Correct Answer is C

Explanation

A. It helps to temporarily lower serum potassium levels by driving potassium into the cells. This effect is usually short-lived and is often used in emergency situations to quickly manage hyperkalemia.
B. Calcium Gluconate is used to stabilize the cardiac membrane in the setting of hyperkalemia, especially if there are ECG changes or symptoms of hyperkalemia. It does not lower the serum potassium level but helps protect the heart from the potential arrhythmias caused by elevated potassium levels.
C. Patiromer (Veltassa) is a potassium binder that helps to remove excess potassium from the body through the gastrointestinal tract. It binds potassium in the gut and facilitates its excretion in the stool.
D. Lisinopril is an ACE inhibitor used to treat hypertension and heart failure. It can actually increase potassium levels by decreasing the excretion of potassium through the kidneys.

A. Sodium polystyrene sulfonate (Kayexalate) B. Bolus with 1 liter of lactated ringer's (LR) C. Renal replacement therapy (RRT) D. Patiromer (Veltassa)

Correct Answer is C

Explanation

A. While this medication is used to treat hyperkalemia, it is a slower acting treatment. Given the patient's critical condition with altered mental status, hyperkalemia, and elevated BUN, a more rapid intervention is needed.
B. Fluid resuscitation is important in some cases of AKI but it is not the priority in this patient. The patient is already showing signs of fluid overload (crackles in the lungs) and the primary issue is the inability of the kidneys to remove waste products and excess fluids.
C. This is the most appropriate treatment for this patient. RRT, such as hemodialysis or continuous renal replacement therapy (CRRT), can rapidly remove waste products, excess fluid, and electrolytes from the blood, correcting the imbalances and improving the patient's condition.
D. This medication is used for long-term management of hyperkalemia, but it is not effective in an acute setting like this.

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During the diuretic phase of acute kidney injury, the nurse understands that the client is at risk for which of the following electrolyte imbalances?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is C

Explanation

Correct Answer is C

Explanation

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