The nurse is caring for a patient with acute kidney injury. The nurse would expect that IV regular insulin and glucose, sodium bicarbonate, and IV calcium gluconate will be used to treat what complication of acute kidney injury?

A. Flush the primary line with saline before and after administering the Protonix: Protonix (pantoprazole) IV push can interact with certain solutions, and compatibility with potassium-containing IV fluids is limited. Flushing the line before and after ensures that the drug is delivered without mixing directly with D5 ½ NS with KCl, preventing precipitation, chemical reactions, or irritation to the vein.

B. Hold the Protonix until the physician rounds: Delaying administration unnecessarily could compromise patient care, particularly if the Protonix is ordered to prevent stress ulcers or gastrointestinal bleeding. The solution is not to withhold the medication but to follow proper IV administration precautions.

C. Call the physician to request an alternate route to administer the Protonix: While alternative routes such as a separate IV line could be used, flushing the existing line is an established and safe procedure. Calling the physician is not immediately necessary unless line access issues prevent safe administration.

D. Administer the Protonix through the primary line at the "Y" port: Administering the IVP medication directly into the primary line without flushing could allow it to mix with the D5 ½ NS with KCl, which may cause incompatibility reactions. Direct injection without flushing increases the risk of precipitation and vein irritation.

A. Provide for delivery of 100% oxygen to the lungs under pressure: PEEP does not specifically deliver 100% oxygen; rather, it maintains alveolar patency at end expiration. Oxygen concentration is set separately on the ventilator.

B. Prevent the fibrotic infiltration of the lung tissue: PEEP does not directly prevent fibrosis. ARDS-related fibrosis is a long-term complication, and PEEP’s role is primarily mechanical, not anti-fibrotic.

C. Apply positive pressure during inhalation to fully inflate the lungs: Positive pressure during inhalation is provided by the tidal volume or inspiratory pressure, not PEEP. PEEP maintains pressure at the end of exhalation, not during inspiration.

D. Prevent alveolar collapse during expiration: PEEP maintains a baseline positive pressure in the lungs at the end of expiration, preventing alveolar collapse (atelectasis). This improves oxygenation, increases functional residual capacity, and reduces ventilator-induced lung injury in ARDS patients.