The nurse is caring for the client with cardiac and renal disease. The client now has a serum potassium level of 6.0 mEq/L. Which medications, if prescribed, should the nurse administer? Select all that apply.
Calcium gluconate 1.5 grams IV now
Dextrose 50% injection (50ml) IV push now
Colace 100 mg PO now
Regular insulin 10 units IV now
Potassium chloride 20 mEq orally now
Correct Answer : A,B,D
A) Calcium gluconate 1.5 grams IV now: Calcium gluconate is administered to counteract the effects of hyperkalemia by stabilizing the myocardial cell membrane. It does not lower potassium levels but helps protect the heart from potential dysrhythmias associated with high potassium levels.
B) Dextrose 50% injection (50ml) IV push now: Dextrose 50% injection, also known as D50W, is administered to temporarily shift potassium from the extracellular space into the intracellular space, thereby lowering serum potassium levels. It is commonly used in combination with insulin to facilitate the movement of potassium into cells.
C) Colace 100 mg PO now: Colace is a stool softener and does not affect serum potassium levels. It is not indicated for the treatment of hyperkalemia.
D) Regular insulin 10 units IV now: Regular insulin is administered with dextrose to facilitate the movement of potassium from the extracellular space into the intracellular space. Insulin stimulates the cellular uptake of glucose, which in turn drives potassium into cells along with glucose.
E) Potassium chloride 20 mEq orally now: Potassium chloride is contraindicated in the treatment of hyperkalemia as it would further increase serum potassium levels. It is typically used to supplement potassium in clients with hypokalemia, not hyperkalemia.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A) "The health care proxy does not go into effect until I am incapable of making decisions.": This statement is accurate. A health care proxy, also known as a durable power of attorney for health care or health care agent, is appointed to make medical decisions on behalf of the client if they become unable to do so themselves. This can include decisions related to treatment options, end-of-life care, and other medical interventions.
B) "I have to choose a family member as my health proxy.": This statement is incorrect. While some individuals may choose a family member as their health care proxy, it is not a requirement. The client can choose any competent adult who is willing to serve as their health care proxy, including a friend, relative, or even a legal representative.
C) "If I become incapacitated, end-of-life choices will be made by my proxy.": This statement is accurate. The health care proxy is responsible for making medical decisions on behalf of the client if they are unable to do so, including decisions related to end-of-life care and treatment preferences.
D) "I can change who I designate as my health care proxy at any time.": This statement is accurate. The client has the right to change their health care proxy at any time by completing a new advance directive document and revoking any previous designations. It is essential for the client to review and update their advance directives regularly to ensure they reflect their current wishes and preferences.
Correct Answer is C
Explanation
A. "It might help if I tried sleeping only on my back."
Sleeping on the back can actually worsen obstructive sleep apnea because gravity can cause the tongue and soft tissues to obstruct the airway more easily. The recommended position to reduce apneic episodes is to sleep on the side.
B. "I’ll sleep better if I take a sleeping pill at night."
Taking a sleeping pill can relax the muscles of the throat, which might worsen sleep apnea by increasing the likelihood of airway obstruction during sleep.
C. "If I could lose about 50 pounds, I might stop having so many apneic episodes."
Weight loss is a key factor in reducing the frequency and severity of obstructive sleep apnea. Excess weight, particularly around the neck, can increase the risk of airway obstruction during sleep.
D. "I’ll get a humidifier to run at my bedside at night."
While a humidifier can make the air more comfortable to breathe, it does not directly reduce the number of apneic episodes. It might help with symptoms like dry mouth or nasal congestion but is not a primary treatment for obstructive sleep apnea.
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