The nurse is caring for a client diagnosed with acute renal failure and has a potassium level of 8.3 mEq/L. What collaborative intervention would be a priority for this client?

Prepare the client for dialysis.

Start an IV and run normal saline at 50m/hour.

Repeat the electrolyte values later in the day

Monitor urine output

Answer and Explanation

The Correct Answer is A

A. Prepare the client for dialysis: A potassium level of 8.3 mEq/L is critically high (normal range: 3.5–5.3 mEq/L), putting the client at immediate risk for life-threatening cardiac arrhythmias (e.g., ventricular fibrillation). Emergency dialysis is needed to remove excess potassium if other interventions (e.g., insulin, calcium gluconate) fail.

B. Start an IV and run normal saline at 50mL/hour: Fluid administration alone does not lower potassium quickly enough in a life-threatening situation.

C. Repeat the electrolyte values later in the day: Delaying treatment would increase the risk of cardiac arrest.

D. Monitor urine output: Although important, monitoring alone does not treat the emergency. Clients with acute renal failure often have little to no urine output.

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Correct Answer is D

Explanation

A. Decreases the chance of peptic ulcer formation: Calcium carbonate is not an antiulcer medication.

B. Prevents constipation: Calcium carbonate can cause constipation, not prevent it.

C. Increases the tubular excretion of potassium: Calcium carbonate does not directly affect potassium excretion.

D. To lower phosphorus levels: Calcium carbonate is a phosphate binder that reduces phosphorus absorption from food. In chronic renal failure, phosphorus builds up due to decreased kidney excretion, leading to secondary hyperparathyroidism and bone disease (renal osteodystrophy).

A. “This is called a thrill and it means that your fistulas not working.” B. "This is not a normal sign will call your provider right away.” C. "This is called a bruit and it shows that your fistula patent." D. “This is called a thrill and it means that your fistula is patent.”

Correct Answer is D

Explanation

A. “This is called a thrill and it means that your fistula is not working.” A thrill is a normal finding and means the fistula is functioning properly.

B. "This is not a normal sign; we will call your provider right away.” A lack of thrill is abnormal, not the presence of one.

C. "This is called a bruit and it shows that your fistula is patent." The thrill is felt and the bruit is heard.

D. "This is called a thrill and it means that your fistula is patent." A thrill (vibration) is a normal finding in an AV fistula and indicates adequate blood flow. A bruit (whooshing sound) is heard on auscultation and also confirms patency.

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The nurse is caring for a client diagnosed with acute renal failure and has a potassium level of 8.3 mEq/L. What collaborative intervention would be a priority for this client?

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Naxlex Comprehensive Predictor Exams

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