The following disease has greater risk of developing hyperkalemia

RRB Nsg. Superintendent -29 April-2025 (shift-2nd)

Medical & Surgical Nursing

Easy

Appeared in: RRB Nsg. Superintendent -29 April-2025 (shift-2nd)

Explanation

The kidneys are the primary organs responsible for excreting excess potassium from the body, accounting for about 90% of potassium removal.
In renal failure, the glomerular filtration rate (GFR) is reduced, which significantly impairs the kidneys' ability to filter and excrete potassium.
This impaired excretion leads to the accumulation of potassium in the bloodstream, resulting in hyperkalemia (serum potassium level above 5.0 mEq/L).
Chronic kidney disease and end-stage renal disease are listed as very common causes of hyperkalemia due to the deficit of functioning nephrons.

Option B: Head injury is not a direct cause of hyperkalemia. It primarily affects sodium and water balance through mechanisms like SIADH (causing hyponatremia) or diabetes insipidus (causing hypernatremia).
Option C: Diarrhea causes the loss of potassium-rich gastrointestinal fluids, which leads to hypokalemia (low potassium levels), not hyperkalemia.
Option D: Dementia is a progressive neurocognitive disorder. It does not have a direct physiological mechanism that would cause potassium retention or hyperkalemia.

Visual 1: Diagram - An illustration of a kidney nephron showing the process of potassium filtration and secretion, highlighting how this process fails in renal disease.
Visual 2: ECG Strip - A comparison of a normal ECG with one showing the characteristic changes of hyperkalemia, such as tall, peaked T-waves, a prolonged PR interval, and a widened QRS complex.

Clinical Relevance

Nursing practice connection: Knowing Pathophysiology and risk factors for hyperkalemia helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
Hyperkalemia is a medical emergency due to its potential to cause life-threatening cardiac arrhythmias, including ventricular fibrillation and asystole. Nurses must be vigilant in monitoring for its signs.
For any patient with known renal impairment, monitoring serum potassium levels is a critical nursing responsibility to prevent severe complications.
Patient education on dietary potassium restriction is a key nursing role in managing chronic kidney disease to prevent episodes of hyperkalemia.

How to Approach the Question

Step 1: Identify the key term in the question, which is 'hyperkalemia', meaning high potassium.
Step 2: Recall the main organ responsible for regulating and excreting potassium from the body. The primary organ is the kidney.
Step 3: Evaluate each option based on its known physiological effects.
Step 4: Consider 'Renal failure'. If the kidneys fail, they cannot excrete potassium, so levels will rise. This is a direct and strong link.
Step 5: Consider 'Diarrhea'. This involves fluid loss from the GI tract, which is rich in potassium. This would cause low potassium (hypokalemia).
Step 6: Consider 'Head injury' and 'Dementia'. These are neurological conditions and are not directly involved in the kidney's or GI tract's handling of potassium. Therefore, they are less likely causes.

Concept Tested & Keywords

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