A patient who is not on any medications is admitted to your unit with severe hypokalemia. Laboratory values taken upon admission to the ED are serum K+, 2.2 mEq/L; BUN, 15 mg/dL; and creatinine, 1.2 mg/dL. Urine output is averaging 45 mL/hr
The ED nurse reports that the patient received a total of 80 mEq of potassium over 4 hours via a right subclavian central venous line. After admission to your unit, the physician orders a repeat potassium level. The result is K+, 2.4 mEq/L. What other information would be beneficial at this time? a. Magnesium level c. Calcium level
b. Repeat creatinine level d. Hemoglobin level
A
The levels of other intracellular electrolytes, such as calcium and potassium, are affected by the level of magnesium The most important functions of magnesium are ensuring the transport of sodium and potassium across the cell membrane and as a co-factor in many intracellular enzyme reactions. Depletion of magnesium liberates potassium to the extracellular fluid, which causes an increase in the excretion of potassium by the kidney and hypokalemia. If the patient has a low magnesium level, it could explain the lack of response to the potassium infusions. The other levels have little effect on serum potassium level or its response to infusions.
You might also like to view...
The nurse is caring for a client with a chest tube after a coronary artery bypass graft. The drainage slows significantly. What action by the nurse is most important?
a. Increase the setting on the suction. b. Notify the provider immediately. c. Re-position the chest tube. d. Take the tubing apart to assess for clots.
Several clients have come to the clinic for immunizations. When reviewing their medical records, the nurse identifies which of the following as a contraindication for the administration of vaccines and toxoids? Select all that apply
A) Acute nonfebrile illness B) Leukemia C) Chronic prednisone therapy D) HIV E) Clients older than 70 years of age
The client's surgery has been delayed because of hyperkalemia. The client doesn't understand why. What is the nurse's best response?
A. "Potassium affects how the heart works and you could have a heart attack if this is not corrected." B. "Your kidneys could quit working during surgery and the surgery would have to be cancelled." C. "We want you to have the best recovery after surgery. Sometimes, if this problem is not corrected before surgery, you may be too sleepy after surgery to talk to your family." D. "By making sure your potassium is normal before surgery, it will keep your heart functioning at its best during your surgery."
A nurse is caring for a client with schizophrenia. The nurse observes that the client is exhibiting avolition, alogia, and anhedonia. Which type of schizophrenic symptoms is this client experiencing?
A) Catatonic B) Negative C) Positive D) Bizarre