A client has been admitted for deterioration of her renal function due to chronic renal failure. Her admission K+ level is 7.8 mEq/L. The nurse would expect to see which of the following abnormalities on her telemetry (ECG) strip? Select all that apply
A) Tachycardia (fast rate) with frequent early ventricular beats (PVCs)
B) Prolonged PR interval with widening of the QRS complex
C) Ventricular fibrillation
D) Atrial flutter with a 2:1 conduction ratio
Ans: B, C
Feedback:
Hyperkalemia decreases membrane excitability, producing a delay in atrial and ventricular depolarization, and it increases the rate of ventricular repolarization. If serum K+ levels continue to rise (above 6 mEq/L), there is a prolongation of the PR interval; widening of the QRS complex with no change in its configuration; and decreased amplitude and widening and eventual disappearance of the P wave. The heart rate may be slow. Ventricular fibrillation and cardiac arrest are terminal events.
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