A client with chronic kidney disease has a serum potassium of 6.8 mEq/L. The nurse reviews the ECG and notes peaked T waves. For each group, select all responses that apply.

Hyperkalemia with ECG changes is a medical emergency. The nurse must notify the provider and monitor cardiac rhythm for dysrhythmias. Administering potassium or high-potassium foods would worsen the condition. Anticipated orders include IV calcium gluconate to stabilize cardiac membranes and IV insulin with dextrose to shift potassium into cells. Spironolactone, a potassium-sparing diuretic, would increase potassium, and IV potassium is contraindicated.

Use the client-specific assessment findings and timing in the scenario rather than a memorized diagnosis label.

Connect the relevant cues to the safest nursing interpretation and action for this exact care setting.

The distractors are plausible in another context but are unsupported, mistimed, lower priority, or incomplete for the findings presented.

Address immediate threats first, stay within nursing scope, and reassess the client after the selected intervention.

For hyperkalemia cues and response, select responses that are both clinically supported and appropriate at this point in care.

• peaked T waves — Tall, narrow T waves on ECG, an early sign of hyperkalemia.
• calcium gluconate — IV medication that antagonizes cardiac effects of hyperkalemia without lowering serum potassium.
• insulin and dextrose — Combination that shifts potassium from extracellular to intracellular space, temporarily lowering serum potassium.