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. 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.

A. Potassium 3.3 mEq/L. hemoglobin 14.1 g/dL, creatinine 0.8 mg/dL B. BUN 5 mg/dL, potassium 4.8 mEq/L, creatinine 0.9 mg/dL C. Potassium 5.4 mEq/L. hemoglobin 9.8 g/dL, creatinine 4.6 mg/dl. D. Potassium 4.5 mEq/L, BUN 18 mg/dL, creatinine 1.1 mg/dL

Correct Answer is C

Explanation

A. These values are within normal ranges.
B. BUN is low, but potassium and creatinine are within normal ranges.
C. Elevated potassium (hyperkalemia), low hemoglobin (anemia), and elevated creatinine are all classic signs of chronic kidney disease.
D. BUN and creatinine are slightly elevated, but not to a level indicative of chronic kidney disease. Potassium is within normal range.

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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

Correct Answer is C

Explanation

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Correct Answer is C

Explanation

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