q5 - raji_321

[ArchivalUser]

5. You have a pt with severe MS that is advanced & progressive who now develops renal
failure secondary to DM, the pt is alert & has elected to put DNR order in place at her
own discretion. The pts K levels are now elevated at 8 meq/l.
Which of the following is most appropriate?
a.dialysis cannot be done because of the DNRorder
b.you can do the dialysis if the DNR is reversed for the procedure
c.go ahead with the dialysis, ignore the DNR order
d.Give kayexalate until DNR status is discussed with the family

[ArchivalUser]

aa.....

[ArchivalUser]

doesnt age matter in such quetions?....bTW....aaaaaaaaaaa

[ArchivalUser]

Ans: c.go ahead with the dialysis, ignore the DNR order
A DNR order is very specifically defined as refraining from CPR efforts such as chest
compressions ,anti arrythmics medications, or electrical cardioversion in the event of
cardiac arrest.
A DNR order has nothing to do with any other forms of care.You should pretend the
DNR order does not exist while evaluating the use for dialysis.
Hyperkalemia is life threatening. It is illogical to use an inferior therapy such as
kayexalate.
The pt;s family is not relevant in making the decision if the pt has the capacity to
understand his or her own medical problems.