Medical Surgical Renal Failure #1

Question

A client in the intensive care unit (ICU) with acute kidney injury is found to have tall, peaked T waves on the electrocardiogram (ECG). An order for administration of polystyrene sulfonate (Kayexalate) is prescribed. The nurse will continue to monitor for which complication the client is experiencing?

Answers

  1. Hypokalemia.
    • Rationale:

      This answer is not correct because hyperkalemia, not hypokalemia, is expected for the client who experiences an acute kidney injury. Acute kidney injury is defined as an abrupt reduction in kidney function based on an elevation in serum creatinine level, a reduction in urine output, the need for renal replacement therapy, or a combination of these factors.

  2. Hypercalcemia.
    • Rationale:

      This answer is not correct because hypocalcemia, not hypercalcemia, is expected for the client who experiences acute kidney injury. Acute kidney injury is defined as an abrupt reduction in kidney function based on an elevation in serum creatinine level, a reduction in urine output, the need for renal replacement therapy, or a combination of these factors.

  3. Hyperkalemia.
    • Rationale:

      This answer is correct because the most common complication associated with acute kidney injury is hyperkalemia which can lead to cardiac dysrhythmia, which is potentially life-threatening. The nurse administers the prescribed Kayexalate to assist in the removal of the potassium and the return to homeostasis.

  4. End stage renal failure.
    • Rationale:

      This answer is not correct because kidney injury does not imply end stage renal failure. Acute kidney injury is defined as an abrupt reduction in kidney function based on an elevation in serum creatinine level, a reduction in urine output, the need for renal replacement therapy, or a combination of these factors.

Overview

Acute kidney injury is defined as an abrupt reduction in kidney function based on an elevation in serum creatinine level, a reduction in urine output, the need for renal replacement therapy, or a combination of these factors.

Explanation

Learning Outcomes

Kidney injury causes retention of fluids and nitrogenous wastes, and as a result, the kidneys cannot regulate electrolytes. This often leads to hyperkalemia, hyperphosphatemia, hypermagnesemia, and hypocalcemia. Due to the elevated serum potassium levels, the ECG reveals peaked T waves. Kayexalate will help remove excess potassium.

Test Taking Tip

Consider the impact that acute kidney injury has on serum electrolyte levels to answer this question correctly.

Video Rationale