A licensed practical/vocational nurse (LPN/LVN) is caring for a ...

[Bob-Dole]

A licensed practical/vocational nurse (LPN/LVN) is caring for a patient with stage 2 chronic kidney disease. Which observation by the RN requires an intervention?
 
  a. The LPN/LVN administers the erythropoietin subcutaneously.
  b. The LPN/LVN assists the patient to ambulate out in the hallway.
  c. The LPN/LVN administers the iron supplement and phosphate binder with lunch.
  d. The LPN/LVN carries a tray containing low-protein foods into the patient's room.

Question 2

A 42-year-old patient admitted with acute kidney injury due to dehydration has oliguria, anemia, and hyperkalemia. Which prescribed actions should the nurse take first?
 
  a. Insert a urinary retention catheter.
  b. Place the patient on a cardiac monitor.
  c. Administer epoetin alfa (Epogen, Procrit).
  d. Give sodium polystyrene sulfonate (Kayexalate).

[jessicaduplan]

Answer to Question 1

ANS: C
Oral phosphate binders should not be given at the same time as iron because they prevent the iron from being absorbed. The phosphate binder should be given with a meal and the iron given at a different time. The other actions by the LPN/LVN are appropriate for a patient with renal insufficiency.

Answer to Question 2

ANS: B
Because hyperkalemia can cause fatal cardiac dysrhythmias, the initial action should be to monitor the cardiac rhythm. Kayexalate and Epogen will take time to correct the hyperkalemia and anemia. The catheter allows monitoring of the urine output but does not correct the cause of the renal failure.

[Bob-Dole]

Thanks for the timely response, appreciate it

[mcarey591]

Gracias!