The patient's potassium level is 7.0 mEq/L. Besides dialysis, which of the following actually reduces plasma potassium levels and total body potassium content safely in a patient with renal dysfunction?
a. Kayexalate
b. Kayexalate with sorbitol
c. Regular insulin
d. Calcium gluconate
A
Only dialysis and administration of cation exchange resins (sodium polystyrene sulfonate [Kayexalate]) actually reduce plasma potassium levels and total body potassium content in a patient with renal dysfunction. In the past, sorbitol has been combined with sodium polystyrene sulfonate powder (Kayexalate) for administration. The concomitant use of sorbitol with Kayexalate has been implicated in cases of colonic intestinal necrosis; therefore, this combination is not recommended. Other treatments, such as administration of regular insulin and calcium gluconate only "protect" the patient for a short time until dialysis or cation exchange resins can be instituted.
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The client with type 1 diabetes mellitus is switching from an animal-source regular insulin to a synthetically derived human regular insulin. Which precaution should the nurse explain to this client?
A. "Human insulin should only be administered in the umbilical area." B. "Do not mix human regular insulin with any other type of insulin." C. "Adjustments in insulin timing may be needed with the human regular insulin." D. "You may notice the need to increase the dose to achieve the same level of glu-cose control."
If a nurse needs to rouse a patient to perform a neurological assessment, the nurse may correctly
1. Skip the neurological assessment if the patient appears to be comatose, since she can't hear the nurse or follow instructions. 2. Exert mild pain on the patient (e.g., pressing on a nailbed). 3. Turn up the volume on the radio or television. 4. Gently slap the patient.
The nursing diagnosis Rape-trauma syndrome applies to a rape victim in the emergency department. Select the most appropriate outcome to achieve before discharging the patient
a. The memory of the rape will be less vivid and less frightening. b. The patient is able to describe feelings of safety and relaxation. c. Symptoms of pain, discomfort, and anxiety are no longer present. d. The patient agrees to a follow-up appointment with a rape victim advocate.
Factors that can cause an insufficient or absent flow of fluid through an IV line include:
A. an IV bag that is placed too low. B. small air bubbles in the IV line. C. a drip chamber that is half full. D. an IV bag that is placed too high.