# A dialysis-dependent adult has potassium 6.8 mmol/L, peaked T waves, and QRS widening. Match each prescribed intervention to its primary role in the emergency plan. > source: MyMerci (mymerci.kr) > url: https://mymerci.kr/pages/nclex_q.php?qn_id=394745&lang=en > language: en > subject: Medication Administration > category: PPT ## Question A dialysis-dependent adult has potassium 6.8 mmol/L, peaked T waves, and QRS widening. Match each prescribed intervention to its primary role in the emergency plan. | | Protect and monitor the myocardium | Shift potassium into cells | Remove potassium from the body | | --- | --- | --- | --- | | Administer prescribed IV calcium while continuous ECG monitoring continues | | | | | Reassess the ECG after calcium and repeat the prescribed calcium dose if toxic changes persist | | | | | Administer prescribed IV insulin with glucose and monitor blood glucose serially | | | | | Administer prescribed nebulized beta2-agonist as an adjunct to insulin-glucose | | | | | Arrange urgent hemodialysis while temporizing treatment is underway | | | | | Administer a prescribed potassium binder as an adjunct, recognizing its slower onset | | | | ## Explanation IV calcium protects the myocardium but does not lower serum potassium; ECG reassessment guides whether further calcium is needed. Insulin with glucose and nebulized beta2-agonist shift potassium into cells temporarily. Urgent hemodialysis removes potassium definitively in a dialysis-dependent client. A potassium binder can contribute to removal but has a slower onset and is an adjunct, not a substitute for immediate cardiac stabilization and temporizing therapy. ## In-depth explanation Correct Answer Rows 1 and 2 protect and monitor the myocardium, rows 3 and 4 shift potassium into cells, and rows 5 and 6 remove potassium from the body. Why It Fits Severe hyperkalemia requires parallel treatment roles. Confusing a stabilizer with a potassium-lowering therapy leaves a critical gap. Clinical Picture Calcium changes cardiac excitability, insulin-glucose and beta2 stimulation buy time, and dialysis removes the excess potassium. A binder acts more slowly. Memory Link Protect, shift, remove: calcium protects; insulin and beta2 shift; dialysis removes. NCLEX Rule With ECG toxicity, give cardiac protection promptly while arranging temporizing treatment and definitive potassium removal. Why the Alternatives Fail Calcium alone does not remove potassium, and a binder alone is too slow for QRS widening. Dialysis does not replace the need for immediate myocardial protection while it is being arranged. Sources 1UK Kidney Association Hyperkalaemia Guideline 22026 NCLEX-RN Test Plan ## Clinical scenario Emergency monitoring and escalation are active. Treatment must protect the myocardium, temporarily shift potassium into cells, and remove potassium from the body; these roles are complementary rather than interchangeable. ## Key concepts - **Hyperkalemia** — An elevated serum potassium level that can impair cardiac conduction. - **Peaked T Wave** — An electrocardiographic change that can occur with elevated potassium. - **Calcium Gluconate** — A medication used to stabilize the myocardium during severe hyperkalemia. ## Related questions - [Before giving a scheduled dose of digoxin, the nurse obtains an apical pulse of 54/min in …](https://mymerci.kr/pages/nclex_q.php?qn_id=374883&lang=en) - [An older adult taking digoxin reports nausea, poor appetite, and yellow-green halos. The a…](https://mymerci.kr/pages/nclex_q.php?qn_id=374884&lang=en) - [A client with diabetes who uses insulin and takes propranolol reports sudden sweating and …](https://mymerci.kr/pages/nclex_q.php?qn_id=374893&lang=en) - [A client with bronchial asthma and current wheezing has a first dose of propranolol prescr…](https://mymerci.kr/pages/nclex_q.php?qn_id=374894&lang=en) - [Which response by the nurse is most appropriate?](https://mymerci.kr/pages/nclex_q.php?qn_id=374901&lang=en) - [Before administering spironolactone, the nurse notes a potassium level of 5.8 mEq/L and ne…](https://mymerci.kr/pages/nclex_q.php?qn_id=374902&lang=en) - [A client taking lisinopril develops sudden swelling of the lips and tongue with hoarseness…](https://mymerci.kr/pages/nclex_q.php?qn_id=374903&lang=en) - [A client taking losartan for hypertension reports a positive home pregnancy test. Which in…](https://mymerci.kr/pages/nclex_q.php?qn_id=374904&lang=en) ## Read in another language - [en](https://mymerci.kr/pages/nclex_q.php?qn_id=394745&lang=en) - [ko](https://mymerci.kr/pages/nclex_q.php?qn_id=394745&lang=ko) - [ja](https://mymerci.kr/pages/nclex_q.php?qn_id=394745&lang=ja) - [zh-TW](https://mymerci.kr/pages/nclex_q.php?qn_id=394745&lang=zh-tw) - [vi](https://mymerci.kr/pages/nclex_q.php?qn_id=394745&lang=vi) --- More free questions: [NCLEX-RN Practice](https://mymerci.kr/pages/nclex_bank.php?lang=en) _For study reference only. Always follow current clinical guidelines and your institution’s protocols._