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The nurse is caring for a client with a kidney injury with a serum potassium level of 6.1 mEq/L (mmol/L) [3.5-5 mEq/L, mmol/L]. Which of the following actions is a priority?
- A. Obtain a prescription for a diuretic to increase urine output
- B. Check the client's sodium level
- C. Place the client on a cardiac monitor
- D. Encourage oral fluid intake
Correct Answer: C
Rationale: Hyperkalemia (6.1 mEq/L) poses a risk for cardiac dysrhythmias, making cardiac monitoring a priority.
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Which nursing intervention would be a priority for a patient receiving 3% saline maintenance fluids?
- A. Monitor serum HCO3-
- B. Monitor urine sodium
- C. Assess blood pressure
- D. Collect 24-hour urine output
Correct Answer: C
Rationale: 3% saline, a hypertonic solution, can cause fluid shifts, making blood pressure monitoring a priority.
The nurse is reviewing the client's laboratory data. Which current prescription should the nurse clarify with the primary healthcare provider (PHCP)?
- A. Dextrose 5% in water (D5W)
- B. dexamethasone
- C. digoxin
- D. ergocalciferol
Correct Answer: A
Rationale: D5W is hypotonic and may worsen hyponatremia, requiring clarification in a client with low sodium levels.
The nurse is placing a client with chronic kidney disease on a cardiac monitor. What is the reason for this action?
- A. Clients with chronic kidney disease are prone to hypertension
- B. Hyperkalemia may result in dysrhythmias
- C. Cardiac monitoring is necessary to evaluate the need for hemodialysis
- D. Clients with chronic kidney disease may experience false episodes of asystole
Correct Answer: B
Rationale: Hyperkalemia, common in CKD, can cause dysrhythmias, necessitating cardiac monitoring.
The nurse is reviewing the assignment for the shift and will be caring for the following clients. Which client is at risk for hypokalemia? A client with
- A. hyperemesis gravidarum.
- B. end-stage renal failure.
- C. diabetic ketoacidosis.
- D. third-degree burns.
Correct Answer: A
Rationale: Hyperemesis gravidarum causes potassium loss through vomiting, increasing hypokalemia risk.
The nurse is reviewing the assessment data for a client with acute glomerulonephritis (AGN). Which of the following would be an expected finding?
- A. Ketonuria
- B. Hematuria
- C. Polyuria
- D. Glycosuria
Correct Answer: B
Rationale: Hematuria is a hallmark of acute glomerulonephritis due to glomerular inflammation.