Of the following clients, which would be at highest risk for developing hyperkalemia?
A) A male admitted for acute renal failure following a drug overdose
B) A client diagnosed with an ischemic stroke with multiple sensory and motor deficits
C) An elderly client experiencing severe vomiting and diarrhea as a result of influenza
D) A postsurgical client whose thyroidectomy resulted in the loss of some of the parathyroid glands
Ans: A
Feedback:
There are three main causes of hyperkalemia: (1) decreased renal elimination; (2) a shift in potassium from the ICF to ECF compartment; and (3) excessively rapid rate of administration. The most common cause of serum potassium excess is decreased renal function. Stroke does not typically have a direct influence on potassium levels, whereas vomiting and diarrhea can precipitate hypokalemia. Loss of the parathyroid influences calcium, not potassium, levels.
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