Editing Medical-Surgical Nursing – RN Practice Questions (section)

==Question 15==
A patient with acute kidney injury has a serum potassium of 6.9 mEq/L, and the cardiac monitor shows peaked T waves with a widening QRS complex. The provider orders several medications. Which one should the nurse recognize as the immediate measure to protect the heart, understanding that it does not lower the serum potassium?
# Intravenous calcium gluconate.
# Intravenous regular insulin with dextrose.
# Oral sodium polystyrene sulfonate or a newer potassium binder.
# Intravenous sodium bicarbonate.

'''Answer:''' Option 1, intravenous calcium gluconate.

''Rationale:'' Calcium gluconate stabilizes the myocardial cell membrane and rapidly reduces the risk of lethal dysrhythmia, but it does not change the serum potassium level. Insulin with dextrose and bicarbonate shift potassium into cells, temporarily lowering the serum level, and binders or dialysis actually remove potassium from the body. Understanding this distinction matters, because cardiac protection is given first while the potassium-lowering measures take effect.

[[Category:Medical-Surgical Nursing]]
[[Category:Registered Nurse (NCLEX-RN)]]
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