A patient is hypokalemic and will be receiving IV potassium. The patient is not on a heart monitor. How should the nurse administer the potassium replacement?

Correct Answer: C

Rationale: When administering IV potassium replacement to a hypokalemic patient who is not on a heart monitor, it is crucial to prevent rapid infusion that may lead to dangerous cardiac complications such as arrhythmias or cardiac arrest. The general guideline is to administer no more than 20 mEq/hour of potassium when the patient is not on continuous cardiac monitoring. This rate allows the body to tolerate the infusion more safely and reduces the risk of serious adverse effects. It is essential for the nurse to closely monitor the patient's response to the potassium replacement and adjust the rate if necessary based on the patient's condition and any signs of potassium-related complications.

Correct Answer: A

Rationale: In a patient with a high serum sodium level (hypernatremia), the goal of treatment is to gradually decrease the sodium concentration in the body to prevent complications. Isotonic solutions (0.9% NS or LR) can worsen hypernatremia because they have a higher sodium concentration than the patient's current serum sodium level. Hypotonic solutions, such as 0.45% NS, are typically used to treat hypernatremia because they have a lower sodium concentration than the patient's serum sodium, which helps dilute the sodium in the body and lower the serum sodium level back to a normal range. Therefore, in this case, the nurse would anticipate administering 0.45% NS to the patient with a serum sodium level of 150 mEq/L.

Correct Answer: B

Rationale: Garlic is known to have antiplatelet and anticoagulant properties. When taken in large amounts, garlic can enhance the effects of anticoagulant medications like warfarin (Coumadin), which can increase the risk of bleeding. Therefore, it is crucial for patients on warfarin therapy to avoid consuming excessive amounts of garlic or garlic supplements to prevent potential interactions and complications.

Correct Answer: B

Rationale: Heparin is an anticoagulant medication used to prevent blood clots. If a patient on heparin therapy experiences excessive bleeding or needs to quickly reverse the anticoagulant effects of heparin, the antidote is protamine sulfate. Protamine sulfate works by neutralizing the effects of heparin by forming a complex with it. It is important for healthcare providers to have protamine sulfate readily available when managing patients on heparin therapy to effectively reverse its anticoagulant effects in emergency situations.

Correct Answer: A

Rationale: Acetaminophen (Tylenol) is primarily metabolized in the liver. Hepatotoxicity is a serious potential side effect of acetaminophen overdose or excessive use. One of the markers for liver damage due to acetaminophen toxicity is an elevated blood urea nitrogen (BUN) level. Normal BUN levels range from 7 to 20 mg/dl, and a level of 60 mg/dl indicates kidney dysfunction, which can result from liver damage caused by acetaminophen toxicity. Therefore, an elevated BUN level would indicate a toxicity of acetaminophen in this client with Bell's palsy who is taking acetaminophen daily. The other laboratory values mentioned are not specific markers for acetaminophen toxicity.