Which action for prevention of complications from hyperkalemia is most important for the nurse to teach the client who is going home but remains at risk for hyperkalemia?
A. Weighing himself or herself daily at the same time of day and in the same amount of clothing
B. Taking his or her radial pulse for a full minute twice each day
C. Ensuring an oral intake of a least 3 liters of fluids per day
D. Restricting sodium as well as potassium intake
B
As potassium levels rise, heart rate decreases and becomes more irregular. By being vigilant for changes in pulse rate, rhythm, and quality, the client can seek medical attention before hyperka-lemia becomes severe.
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What patient response to the Tensilon test leads the nurse to suspect myasthenia gravis? a. The patient's ptosis is temporarily improved. b. The patient becomes dyspneic. c. The patient's muscles become very weak. d. The patient develops muscle cramps.
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The nurse cares for an older adult who has a prealbumin level of 10 mg/dl and an infection in a large wound. Which intervention is the nurse's priority?
a. Monitor temperature and leukocytes. b. Provide assistance with meal planning. c. Provide high-quality protein in the diet. d. Maintain oxygen saturation above 95%.
A nurse is educating a group of nursing students about the immediate reactions that may occur after administering antivenins. Within which of the following time periods will the immediate reaction be seen if the client is sensitive to the antivenin?
A) 30 minutes B) 60 minutes C) 90 minutes D) 120 minutes