a client with chronic kidney disease ckd is experiencing hyperkalemia which intervention should the nurse implement to address this condition
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Nursing Elites

ATI LPN

ATI PN Adult Medical Surgical 2019

1. A client with chronic kidney disease (CKD) is experiencing hyperkalemia. Which intervention should the nurse implement to address this condition?

Correct answer: A

Rationale: Administering calcium gluconate is the appropriate intervention for a client with hyperkalemia. Calcium gluconate helps stabilize the heart by counteracting the effects of high potassium levels and reducing the risk of cardiac complications in individuals with hyperkalemia. Choices B, C, and D are incorrect. Encouraging a diet high in potassium or providing potassium supplements would exacerbate hyperkalemia. Restricting sodium intake is not directly related to addressing hyperkalemia.

2. A 38-year-old male client collapsed at his outside construction job in Texas in July. His admitting vital signs to ICU are, BP 82/70, heart rate 140 beats/minute, urine output 10 ml/hr, skin cool to the touch. Pulmonary artery (PA) pressures are, PAWP 1, PAP 8/2, RAP -1, SVR 1600. What nursing action has the highest priority?

Correct answer: B

Rationale: The correct answer is to increase the client's IV fluid rate to 200 ml/hr. The client's vital signs indicate signs of shock and hypovolemia, making fluid resuscitation the priority to address these conditions. Improving intravascular volume is crucial to stabilize the client's blood pressure, heart rate, and urine output, ultimately improving organ perfusion and addressing the underlying issue of hypovolemia.

3. A patient with rheumatoid arthritis is taking prednisone. What is an important side effect for the nurse to monitor?

Correct answer: A

Rationale: The correct answer is hyperglycemia. Prednisone, a corticosteroid, can lead to elevated blood sugar levels as a side effect, particularly in patients with diabetes or those predisposed to developing diabetes. Monitoring for hyperglycemia is crucial to prevent complications like diabetic ketoacidosis and hyperglycemic hyperosmolar syndrome.

4. A 70-year-old man presents with weight loss, jaundice, and a palpable mass in the right upper quadrant. Laboratory tests reveal elevated bilirubin and alkaline phosphatase levels. What is the most likely diagnosis?

Correct answer: C

Rationale: The presentation of a 70-year-old man with weight loss, jaundice, a palpable mass in the right upper quadrant, and elevated bilirubin and alkaline phosphatase levels is highly suggestive of pancreatic cancer. This clinical scenario, known as Courvoisier's sign, points towards a pancreatic malignancy due to biliary obstruction. Gallstones could cause similar symptoms but would typically not present with a palpable mass. Hepatitis usually does not present with a palpable mass and would have different laboratory findings. Primary biliary cirrhosis typically presents differently with chronic cholestasis without the presence of a palpable mass or a pancreatic lesion.

5. The nurse is administering sevelamer (RenaGel) during lunch to a client with end-stage renal disease (ESRD). The client asks the nurse to bring the medication later. The nurse should describe which action of RenaGel as an explanation for taking it with meals?

Correct answer: B

Rationale: Sevelamer (RenaGel) binds with phosphorus in foods to prevent its absorption, which is why it should be taken with meals. By taking RenaGel with meals, it can effectively bind with phosphorus from food, reducing the amount of phosphorus absorbed by the body, thus helping to manage hyperphosphatemia in clients with ESRD. Choices A, C, and D are incorrect because RenaGel's primary action is to bind with phosphorus in foods, not related to preventing indigestion, promoting stomach emptying, or buffering hydrochloric acid.

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