Editing Anatomy and Physiology – RN Practice Questions (section)

==Question 5==
A patient with chronic kidney disease has a serum potassium of 6.8 mEq/L. Which findings would the nurse expect to assess or anticipate? '''Select all that apply.'''
# Peaked T waves on the cardiac monitor.
# Generalized skeletal muscle weakness.
# Positive Chvostek sign.
# Cardiac dysrhythmias, including bradycardia and asystole.
# Increased urine output with dilute urine.

'''Answer:''' 1, 2, and 4 (A, B, D).

''Rationale:'' Potassium is the principal intracellular cation and sets the resting membrane potential. A high extracellular potassium concentration reduces the gradient, making cells initially more excitable and then unable to repolarize normally. On the electrocardiogram this appears as tall peaked T waves, then a widened QRS, and finally bradycardia, ventricular dysrhythmias, and asystole. Skeletal muscle is affected the same way, producing weakness. Option 3 is incorrect because a positive Chvostek sign reflects the neuromuscular irritability of hypocalcemia, not hyperkalemia. Option 5 is incorrect because chronic kidney disease with hyperkalemia is typically associated with reduced, not increased, urine output; the failing kidney is the reason potassium is being retained.