The nurse is caring for a client following hemodialysis. The ...

[CharlieWard]

The nurse is caring for a client following hemodialysis. The nursing assessment reveals the client is tachycardic; has pale, cool skin; and has a decreased urine output.
 
  Based on this data, the nurse determines that the client has not met which expected outcome associated with hemodialysis?
  A) Cardiac decompensation
  B) The pharmacological effects of a diuretic infused in the dialysate
  C) The effects of rapidly infused intravenous fluids
  D) A reduction of extracellular fluid

Question 2

The nurse is caring for a client with a potassium level of 5.9 mEq/L. The health care provider prescribes both glucose and insulin for the client. The client's spouse asks, Why is insulin needed? Which response by the nurse is the most appropr
 
  A) The insulin will cause his extra potassium to move into his cells, which will lower potassium in the blood.
  B) Insulin is safer than other medications that can lower potassium levels.
  C) The insulin lowers his blood sugar levels and this is how the extra potassium is excreted.
  D) The insulin will help his kidneys excrete the extra potassium.

[reelove4eva]

Answer to Question 1

Answer: D

The client on hemodialysis is expected to have a reduction of extracellular fluid, not a fluid deficit that puts the client at risk. Diuretics and IV fluids are not administered during hemodialysis. Cardiac decompensation would not be an expected outcome of treatment.

Answer to Question 2

Answer: A

Serum potassium levels may be temporarily lowered by administering glucose and insulin, which cause potassium to leave the extracellular fluid and enter cells. Giving insulin to decrease serum potassium levels is not considered a safer method than other medications that can be used. Insulin does not promote renal excretion of potassium. Serum potassium is lowered by entering the cells; this is not controlled by serum glucose.