Question

A patient with acute kidney injury has been admitted to the hospital, and the nurse observes the electrocardiogram (ECG) reading shows tall peaked T waves, ST depression, and QRS widening. What nursing interventions should the nurse perform for this patient? Select all that apply.

A. Ensure potassium intake of 50 mEq/day.
B. Administer regular insulin intravenously.
C. Administer sodium bicarbonate.
D. Administer diuretics as ordered.
E. Administer calcium gluconate intravenously.

Answer 1

Essential nursing interventions for a patient with acute kidney injury and signs of hyperkalemia include administering regular insulin and sodium bicarbonate intravenously, and providing calcium gluconate to stabilize cardiac function. Increasing potassium intake would be contraindicated, and diuretics must be used cautiously.

Step-by-step explanation:

A patient with acute kidney injury presenting with tall peaked T waves, ST depression, and QRS widening on an ECG is likely experiencing hyperkalemia. The appropriate nursing interventions for this patient should address the hyperkalemia and aim to stabilize the patient's cardiac function. Administering regular insulin intravenously is an intervention used to reduce potassium levels in the blood by driving potassium from the extracellular fluid into the cells. Administering sodium bicarbonate can help by shifting potassium into cells and correcting metabolic acidosis, which often accompanies kidney injury. Additionally, administering calcium gluconate intravenously can help to counteract the toxic effects of high potassium levels on the heart by stabilizing the cardiac membrane potential.

Interventions such as 'ensure potassium intake of 50 mEq/day' would be contraindicated as it could worsen the hyperkalemia. While administering diuretics may be ordered in some cases, it should be done with caution, depending on the patient's overall fluid and electrolyte balance and kidney function.