Question

a client in the later stages of chronic kidney disease (ckd) has hyperkalemia. with ckd, what other factors besides tissue breakdown can cause high potassium levels? select all that apply.
answer options
1 blood transfusions
2 metabolic alkalosis
3 bleeding or hemorrhage
4 decreased sodium excretion

Explanation:

• Blood transfusions: Old blood has higher potassium levels as cells break down over time.
• Bleeding or hemorrhage: Tissue breakdown (including in case of bleeding/hemorrhage) releases potassium from cells.
• Injection of potassium in medications: Directly adds potassium to the body.

Metabolic alkalosis causes potassium to shift into cells (lowering serum potassium in some cases, not increasing). Decreased sodium excretion is more related to sodium - water balance rather than potassium levels in the context of causing hyperkalemia here.

Answer:

1. Blood transfusions
2. Bleeding or hemorrhage
3. Injection of potassium in medications