The nurse receives a health care provider's prescription to change a patient's IV from D5. half-normal saline with 40 mEq KCl/L to DSNS with 20 mEq KCl/L. Which set of serum laboratory values supports the rationale for this IV prescription change?
Sodium level of 136 mEq/L, potassium level of 4.5 mEq/L.
Sodium level of 145 mEq/L, potassium level of 4.8 mEq/L.
Sodium level of 135 mEq/L, potassium level of 3.6 mEq/L.
Sodium level of 144 mEq/L, potassium level of 3.7 mEq/L.
The Correct Answer is C
Choice A rationale:
The sodium level is within the normal range, but the potassium level is slightly elevated. This does not support the rationale for changing the IV prescription to a lower potassium concentration.
Choice B rationale:
The sodium level is slightly elevated, and the potassium level is within the normal range. This does not support the rationale for changing the IV prescription to a lower potassium concentration.
Choice C rationale:
Sodium level of 135 mEq/L, potassium level of 3.6 mEq/L is the correct answer. In this option, both sodium and potassium levels are within normal ranges. Changing the IV prescription to DSNS with 20 mEq KCl/L ensures that the patient receives adequate hydration (from the dextrose and normal saline) without causing hyperkalemia.
Choice D rationale:
The sodium level is slightly elevated, and the potassium level is within the normal range. This does not support the rationale for changing the IV prescription to a lower potassium concentration.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A rationale:
While leukemia treatment does have severe side effects, not all of them are permanent. It is essential for the patient to be aware of potential complications but also to understand that some side effects might be temporary and can be managed with appropriate care.
Choice B rationale:
Using the call light to ask for help when getting out of bed is essential for patients receiving chemotherapy, as their immune system might be compromised, making them prone to infections and injuries. However, this information is not specific to leukemia treatment but is a general safety measure for these patients.
Choice C rationale:
Patients undergoing chemotherapy for leukemia are at an increased risk of infections due to the suppression of the immune system. Preventive measures, such as good hygiene practices and early detection of signs of infection, are crucial in managing these patients. Educating the patient about infection prevention is essential for their safety during treatment.
Choice D rationale:
Feeling isolated can be a common emotional response to any chronic illness, including leukemia. However, it is not an unavoidable consequence, and providing emotional support and involving the patient in support groups can help mitigate these feelings. This statement does not provide essential information about managing leukemia treatment.
Correct Answer is D
Explanation
The correct answer is choice d. pH = 7.52, PaCO2 = 24 mm Hg, PaO2 = 85 mm Hg, and HCO3 = 24 mEq/L.
Rationales:
Choice A rationale:
- pH = 7.46: This value is slightly alkalotic.
- PaCO2 = 44 mm Hg: This is within the normal range (35-45 mm Hg), indicating that the respiratory system is not contributing to alkalosis.
- PaO2 = 95 mm Hg: This is a normal oxygen level.
- HCO3 = 36 mEq/L: This is elevated, indicating metabolic alkalosis rather than respiratory alkalosis.
Choice B rationale:
- pH = 7.27: This value is acidic, indicating acidosis.
- PaCO2 = 70 mm Hg: This is elevated, indicating respiratory acidosis.
- PaO2 = 80 mm Hg: This is slightly low, indicating mild hypoxemia.
- HCO3 = 26 mEq/L: This is within the normal range, indicating no metabolic compensation.
Choice C rationale:
- pH = 7.30: This value is acidic, indicating acidosis.
- PaCO2 = 35 mm Hg: This is within the normal range, indicating that the respiratory system is not contributing to acidosis.
- PaO2 = 70 mm Hg: This is low, indicating hypoxemia.
- HCO3 = 20 mEq/L: This is low, indicating metabolic acidosis.
Choice D rationale:
- pH = 7.52: This value is alkalotic.
- PaCO2 = 24 mm Hg: This is low, indicating respiratory alkalosis.
- PaO2 = 85 mm Hg: This is a normal oxygen level.
- HCO3 = 24 mEq/L: This is within the normal range, indicating no metabolic compensation.
Choice D corresponds with respiratory alkalosis because the pH is alkalotic, and the PaCO2 is low, indicating that the respiratory system is causing the alkalosis. The HCO3 is within the normal range, showing no metabolic compensation.
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