Pre-Test 1 and 2: Introduction to Special Questions Based on Official NCLEX-RN[®]
39. The K+ level of a client in acute renal failure is 6.8 mEq/L. Which treatments will decrease the potassium level? Select all that apply.
Pre-Test 1 and 2: Introduction to Special Questions Based on Official NCLEX-RN[®]
39. The K+ level of a client in acute renal failure is 6.8 mEq/L. Which treatments will decrease the potassium level? Select all that apply.
. Rapid infusion of 50% dextrose.
. Sodium bicarbonate IV.
. Regular insulin in D5W.
. Kayexalate retention enema.
. Albuterol sulfate (Ventolin) by nebulizer.
Test-Taking Tip
Review current treatment approaches for hyperkalemia.
Content Area: Adult Health, Renal; Integrated Process: Nursing Process, Analysis; Cognitive Level: Application; Client Need/Subneed: Physiological Integrity/Pharmacological and Parenteral Therapies/Expected Effects/Outcomes
Pre-Test 1 and 2: Introduction to Special Questions Based on Official NCLEX-RN[®]
. . . .
Answer 1 is incorrect because dextrose alone will not directly affect the potassium level. Insulin also needs to be given. Answer 2 is correct because correcting the acidosis with sodium bicarbonate will cause potassium to shift back into the cell. Answer 3 is correct because regular insulin is the first line of treatment for hyperkalemia. Dextrose is used to prevent hypoglycemia, which may occur with the shift of the potassium back into the cell. Answer 4 is correct because Kayexalate is an exchange resin. Potassium is exchanged for Na+ in the intestines, and potassium is removed via feces. Answer 5 is correct because albuterol has been shown to decrease the potassium level by 0.5 to 1.5 mEq/L.