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
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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Related Questions
Correct Answer is D
Explanation
A. Decreases the chance of peptic ulcer formation: Calcium carbonate is not an antiulcer medication.
B. Prevents constipation: Calcium carbonate can cause constipation, not prevent it.
C. Increases the tubular excretion of potassium: Calcium carbonate does not directly affect potassium excretion.
D. To lower phosphorus levels: Calcium carbonate is a phosphate binder that reduces phosphorus absorption from food. In chronic renal failure, phosphorus builds up due to decreased kidney excretion, leading to secondary hyperparathyroidism and bone disease (renal osteodystrophy).
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.
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