A nurse is caring for a client who has hyperkalemia and is to receive intravenous insulin. Which of the following should the nurse recognize as an adverse outcome?

Serum potassium 4.8 mmol/l

Serum glucose 58 mg/d

Serum sodium 138 mEq/L

Calcium level of 100 mg

Answer and Explanation

The Correct Answer is B

A. Serum potassium 4.8 mmol/L: This is a normal potassium level (3.5–5.0 mmol/L) and indicates successful treatment.

B. Serum glucose 58 mg/dL: IV insulin drives potassium into cells, lowering serum potassium. However, insulin also lowers blood glucose, which can lead to hypoglycemia (glucose <70 mg/dL). Hypoglycemia is the primary adverse effect of IV insulin therapy.

C. Serum sodium 138 mEq/L: This is a normal sodium level (135–145 mEq/L) and not an adverse effect.

D. Calcium level of 100 mg: Calcium is not directly affected by IV insulin therapy.

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Correct Answer is B

Explanation

A. "We'll find out if any medications, such as steroids, are interfering with your kidney function." Some medications affect kidney function, but creatinine primarily measures kidney efficiency, not drug interactions.

B. "This test will tell your doctor how your kidneys are functioning." Serum creatinine is a key indicator of kidney function. It measures how well the kidneys are filtering waste products.

C. "This test will tell if you have severe renal impairment or disease." Creatinine can be elevated in mild, moderate, or severe kidney dysfunction, not just in severe disease.

D. "You'll have to ask your doctor." The nurse should provide basic health education to the client.

A. Bradypnea, dizziness, and paresthesia B. Bradycardia and hyperactivity C. Headache, restlessness and confusion. D. Irritability and seizures

Correct Answer is C

Explanation

A. Bradypnea, dizziness, and paresthesia: Bradypnea is associated with CO₂ retention, but paresthesia (tingling sensations) is more common in alkalosis due to calcium shifts.

B. Bradycardia and hyperactivity: Bradycardia can occur in severe acidosis, but hyperactivity is not a typical sign.

C. Headache, restlessness, and confusion: Respiratory acidosis occurs when CO₂ retention leads to cerebral vasodilation, increasing intracranial pressure and causing headache, restlessness, and confusion.

D. Irritability and seizures: Seizures are more common in severe alkalosis due to neuronal hyperexcitability.

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A nurse is caring for a client who has hyperkalemia and is to receive intravenous insulin. Which of the following should the nurse recognize as an adverse outcome?

Nursing Test Bank

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