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NCLEX-RN · Question #480

A 48-year-old client is in the surgical intensive care unit after having had three-vessel coronary artery bypass surgery yesterday. She is extubated, awake, alert and talking. She is receiving…

The correct answer is D. Serum potassium is low. The nurse should administer KCl as ordered. (A) An elevated serum osmolality poses no immediate danger and is not corrected rapidly. (B) A low serum sodium alone does not warrant changing IV fluids to normal saline. Other assessment parameters, such as hydration status, must be considered. (C) A low serum blood urea…

Physiological Integrity: Pharmacological and Parenteral Therapies

Question

A 48-year-old client is in the surgical intensive care unit after having had three-vessel coronary artery bypass surgery yesterday. She is extubated, awake, alert and talking. She is receiving digitalis for atrial arrhythmias. This morning serum electrolytes were drawn. Which abnormality would require immediate intervention by the nurse after contacting the physician?

Options

  • ASerum osmolality is elevated indicating hemoconcentration. The nurse should increase IV fluid
  • BSerum sodium is low. The nurse should change IV fluids to normal saline.
  • CBlood urea nitrogen is subnormal. The nurse should increase the protein in the client's diet as soon
  • DSerum potassium is low. The nurse should administer KCl as ordered.

How the community answered

(54 responses)
  • A
    4% (2)
  • B
    22% (12)
  • C
    11% (6)
  • D
    63% (34)

Explanation

(A) An elevated serum osmolality poses no immediate danger and is not corrected rapidly. (B) A low serum sodium alone does not warrant changing IV fluids to normal saline. Other assessment parameters, such as hydration status, must be considered. (C) A low serum blood urea nitrogen is not necessarily indicative of protein deprivation. It may also be the result of overhydration. (D)A low serum potassium potentiates the effects of digitalis, predisposing the client to dangerous arrhythmias. It must be corrected immediately.

Topics

#digitalis toxicity#hypokalemia#coronary artery bypass#electrolyte imbalance

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