A renal failure patient with severe hyperkalemia (K+ level 7.2 ...

[elizabeth18]

A renal failure patient with severe hyperkalemia (K+ level 7.2 mEq/L) has just been admitted to the nursing unit. Given the severity of this situation, the nurse should be prepared to administer which intravenous infusion stat?
 
  A)
  Lactated Ringer solution at 150 mL/hour to maintain blood glucose levels
  B)
  Regular insulin infusion, rate dependent on lab values
  C)
  Infusion of Solu-Medrol to decrease irritation to the intravascular system
  D)
  Dilaudid via patient-controlled device (PCA) to control pain

Question 2

Which of the following medications used in the treatment of peptic ulcers and gastroesophageal reflux binds to H2 receptors and blocks the action of histamine on parietal cells?
 
  A)
  Cimetidine (Tagamet)
  B)
  Levbid (hyoscyamine)
  C)
  Lotronex (alosetron)
  D)
  Nexium (esomeprazole)

[mirabriestensky]

Answer to Question 1

Ans:
B

Feedback:

The administration of sodium bicarbonate, -adrenergic agonists, or insulin distributes potassium into the ICF compartment and rapidly decreases the ECF concentration. Lactated Ringer solution, steroids, or narcotics will not help to lower potassium levels.

Answer to Question 2

Ans:
A

Feedback:

Cimetidine is a H2 receptor blocker used to treat peptic ulcers and GERD. It binds to H2 receptors and blocks the action of histamine on parietal cells. Levbid and Lotronex are anticholinergics, while Nexium is a proton pump inhibitor that inhibits gastric acid secretion.