The client has a history of renal failure and is receiving hemodialysis. The nurse should monitor for which electrolyte imbalance.
Hyperkalemia.
Hypokalemia.
Hyponatremia.
Hypernatremia.
The Correct Answer is A
This is because hemodialysis removes excess fluid and waste products from the blood, but it also removes some electrolytes, such as potassium.
Potassium is important for nerve and muscle function, especially the heart.
If potassium levels are too high or too low, it can cause irregular heartbeat or cardiac arrest.
Choice B is wrong because hypokalemia means low potassium levels, which is unlikely in renal failure unless there is excessive potassium loss from diarrhea, vomiting or diuretics.
Choice C is wrong because hyponatremia means low sodium levels, which can occur in renal failure due to fluid retention, but it is not directly related to hemodialysis.
Choice D is wrong because hypernatremia means high sodium levels, which can occur in renal failure due to reduced urine output, but it is also not directly related to hemodialysis.
Normal ranges for electrolytes are: Potassium: 3.5 to 5.0 mmol/L
Sodium: 135 to 145 mmol/L
Calcium: 8.5 to 10.5 mg/dL
Chloride: 96 to 106 mmol/L
Magnesium: 1.7 to 2.2 mg/dL
Phosphate: 2.5 to 4.5 mg/dL
Bicarbonate: 22 to 29 mmol/L
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
This is because hyperkalemia is a condition where the blood potassium level is too high.
This can cause cardiac arrhythmias, muscle weakness, and paralysis. Therefore, the nurse should administer intravenous insulin and glucose to lower the blood potassium level by shifting it into the cells.
Choice A is wrong because encouraging the patient to consume a high- potassium diet would increase the blood potassium level and worsen the condition.
Choice C is wrong because administering a potassium-sparing diuretic would prevent the excretion of excess potassium and aggravate the hyperkalemia.
Choice D is wrong because encouraging the patient to limit fluid intake is not relevant to the management of hyperkalemia and may cause dehydration.
Correct Answer is C
Explanation
This is because intravenous potassium supplementation is indicated for patients with profound hypokalemia (plasma K+ <2.5 mmol/L) or cardiac arrhythmia. The rate of infusion should not exceed 10 mmol/hour to prevent complications such as hyperkalemia, cardiac arrhythmias, and phlebitis.
Choice A is wrong because monitoring urine output every 8 hours is not sufficient to prevent complications from intravenous potassium replacement therapy.
Urine output should be monitored more frequently (at least every 4 hours) to assess renal function and fluid balance.
Choice B is wrong because administering potassium via a bolus injection is dangerous and can cause fatal cardiac arrhythmias.
Potassium should never be given by intravenous push or intramuscular injection.
Choice D is wrong because encouraging the client to eat potassium-rich foods is not appropriate for patients receiving intravenous potassium replacement therapy.
Oral potassium supplementation is preferred for patients with mild to moderate hypokalemia (plasma K+ 2.5-3.5 mmol/L) who can eat and absorb oral potassium.
Potassium-rich foods include potatoes, legumes, juices, seafood, leafy greens, dairy, tomatoes and bananas.
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