Physiological Adaptation Q 177

---

Patrick is in the oliguric phase of acute tubular necrosis and is experiencing fluid and electrolyte imbalances. The client is somewhat confused and complains of nausea and muscle weakness. As part of the prescribed therapy to correct this electrolyte imbalance, the nurse would expect to:

  

     A. Administer Kayexalate

     B. Restrict foods high in protein

     C. Increase oral intake of cheese and milk.

     D. Administer large amounts of normal saline via I.V.

    

    

Correct Answer: A. Administer Kayexalate

---

Kayexalate, a potassium exchange resin, permits sodium to be exchanged for potassium in the intestine, reducing the serum potassium level.

---

Option B: Higher protein intake can increase intraglomerular pressure, which is useful in the short term when the client eats a large protein meal with high-protein content so that one can ensure effective clearance of nitrogenous end products that are produced from eating too much protein.

Option C: Phosphorus, which is abundant in dairy products, draws calcium out of the bones when it builds up in the blood. Clients with renal diseases may eat some of these foods in very small amounts.

Option D: Although 0.9% saline and balanced fluids can both lead to renal volume expansion, interstitial fluid retention, and adverse intra-renal microvascular effects are more pronounced with 0.9% saline infusion.

---