The morning laboratory results of a patient admitted with heart failure reveal a

serum potassium level of 2.9 mEq/L. Which classification of medications would be

withheld until consulting with the health care provider?

1

Antibiotics

Correct2

Loop diuretics

3

Bronchodilators

4

Antihypertensives

Loop diuretics are contraindicated during episodes of hypokalemia because these medications cause the

kidneys to excrete sodium and potassium. Thus administration of this type of medication at this time

would worsen the hypokalemia, putting the patient at risk for dysrhythmias. The prescribing health care

provider should be consulted for potassium replacement therapy, and the drug should be withheld until

the potassium has returned to normal range. Antibiotics, bronchodilators, and antihypertensives are not

an issue in this case.

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2. 12686574086

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2.

The IV prescription reads "1000 mL of D5.45 normal saline (NS) with 40 mEq

KCl/L at 125 mL/hour." The nurse needs to add KCl to the liter of D5.45 NS solution

because no premixed solutions are available. The unit's medication supply has a

stock of KCl 5 mEq/mL in multidose vials. The nurse would need to draw up

__________ mL of KCl to add to the IV solution. Record your answer using a whole

number.

The end concentration of the KCl is listed on the vial as follows: "5 mEq/mL." Using ratio and proportion,

multiply 5 by x and multiply 40 × 1 to yield 5x = 40. Divide 40 by 5 to yield 8 mL. The nurse would add 8

mL of KCl to the 1000 mL of D5.45 NS.

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3.

Which process of molecule transport would occur when a patient develops pedal

edema and their blood pressure is 160/90 mm Hg?

Correct1

Osmosis

2

Diffusion

3

Active transport

4

Facilitated diffusion

A patient with blood pressure of 160/90 mm Hg has hypertension and develops pedal edema due to

excess sodium in the blood. This leads to movement of water down the gradient. Therefore the water

from the blood vessels moves from higher concentrations to lower concentration across the

semipermeable membrane with the help of osmotic pressure and leads to accumulation of water in the

extracellular spaces. This movement of water across a semipermeable membrane to balance the solute is

called osmosis. Diffusion and facilitated diffusion involve molecules moving from a higher to lower

concentrations, and active transport involves molecules moving from a lower to higher concentration.

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4.

Which solution would the nurse select as the most effective means of killing

harmful bacteria when preparing to cleanse the skin around a central venous access

device?

1

Sterile saline solution

2

Isopropyl alcohol solution

3

Povidone-alcohol solution

Correct4

Chlorhexidine-based solution

Chlorhexidine-based solutions such as chlorhexidine gluconate have been shown to be more effective at

killing bacteria than povidone-alcohol or isopropyl alcohol solutions. Therefore chlorhexidine-based

solutions should be used to cleanse around the central venous access device. A sterile saline solution

does not have any antiseptic properties.

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