217) ANSWER
C) Sodium bicarbonate, to make the client alkalotic so the potassium will shift into the ECF
RATIONALE
Sodium bicarbonate will temporarily alkalinize the plasma, causing the potassium to move into the cells. NS is an isotonic solution, and therefore will not cause fluid or electrolyte shifting. Calcium gluconate is given to blunt the effects on the myocardium; it does not decrease the serum K level. Insulin and dextrose are given to decrease K levels by increasing K uptake at the cellular level. A critical word is acidosis. Recall that potassium is increased in acidosis to direct you to option 3, in which alkalosis is the goal of treatment.
C) Sodium bicarbonate, to make the client alkalotic so the potassium will shift into the ECF
RATIONALE
Sodium bicarbonate will temporarily alkalinize the plasma, causing the potassium to move into the cells. NS is an isotonic solution, and therefore will not cause fluid or electrolyte shifting. Calcium gluconate is given to blunt the effects on the myocardium; it does not decrease the serum K level. Insulin and dextrose are given to decrease K levels by increasing K uptake at the cellular level. A critical word is acidosis. Recall that potassium is increased in acidosis to direct you to option 3, in which alkalosis is the goal of treatment.
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