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 C

Explanation

A. Administer supplemental oxygen: Hypokalemia primarily affects cardiac and neuromuscular function, not oxygenation. Oxygen may be needed if dysrhythmias develop but is not the highest priority.

B. Seizure precautions: While severe hypokalemia can cause muscle weakness, seizures are not the primary concern. Cardiac effects take priority.

C. Cardiac monitoring: A potassium level of 2.2 mEq/L is critically low, increasing the risk of life-threatening cardiac arrhythmias. Continuous cardiac monitoring helps detect dangerous dysrhythmias like ventricular tachycardia.

D. Initiating a fluid restriction: Fluid restriction is more relevant for hyperkalemia or fluid overload, not hypokalemia.

A. Decreases the chance of peptic ulcer formation B. Prevents constipation. C. increases the tubular excretion of potassium D. To lower phosphorus level

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).

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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?

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Naxlex Comprehensive Predictor Exams

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