A child is hospitalized in acute renal failure and has a serum ...

[clmills979]

A child is hospitalized in acute renal failure and has a serum potassium greater than 7 mEq/L. What temporary measures that will produce a rapid but transient effect to reduce the potassium should the nurse expect to be prescribed? (Select all that apply.
 
  a. Dialysis
  b. Calcium gluconate
  c. Sodium bicarbonate
  d. Glucose 50 and insulin
  e. Sodium polystyrene sulfonate (Kayexalate)

Question 2

What dietary instructions should the nurse give to parents of a child in the oliguria phase of acute glomerulonephritis with edema and hypertension? (Select all that apply.)
 
  a. High fat
  b. Low protein
  c. Encouragement of fluids
  d. Moderate sodium restriction
  e. Limit foods high in potassium

[Dinolord]

Answer to Question 1

ANS: B, C, D
Several measures are available to reduce the serum potassium concentration, and the priority of implementation is usually based on the rapidity with which the measures are effective. Temporary measures that produce a rapid but transient effect are calcium gluconate, sodium bicarbonate, and glucose 50, and insulin. Definitive but slower-acting measures are then implemented which include administration of a cation exchange resin such as sodium polystyrene sulfonate (Kayexalate), 1 g/kg, administered orally or rectally, and/or dialysis.

Answer to Question 2

ANS: D, E
Dietary restrictions depend on the stage and severity of acute glomerulonephritis, especially the extent of edema. A regular diet is permitted in uncomplicated cases, but sodium intake is usually limited (no salt is added to foods). Moderate sodium restriction is usually instituted for children with hypertension or edema. Foods with substantial amounts of potassium are generally restricted during the period of oliguria. Protein restriction is reserved only for children with severe azotemia resulting from prolonged oliguria. A low-protein, high-fat diet with encouragement of fluids would not be recommended.

[clmills979]

Correct answers!

[Dinolord]

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