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. Hypercalcemia: AKI is typically associated with hypocalcemia because the kidneys fail to convert vitamin D to its active form, reducing calcium absorption.

B. Elevated BUN: AKI leads to impaired renal filtration, causing elevated blood urea nitrogen (BUN) and creatinine levels due to the accumulation of nitrogenous waste.

C. Metabolic alkalosis: AKI usually causes metabolic acidosis, not alkalosis, due to the accumulation of acids (e.g., lactic acid, uremic toxins).

D. Hypokalemia: AKI commonly leads to hyperkalemia due to reduced potassium excretion.

A. Abdomen rigid with decreased bowel sounds B. Glucose 220mg/d C. No dialysis for 24 hours D. Crackles throughout the lungs E. WBC 17,000 mm3 F. Hemoglobin 10g/dL G. Potassium 7mEq/L H. Creatinine 3 mg/dL

Correct Answer is ["A","B","D","E","G"]

Explanation

A. Abdomen rigid with decreased bowel sounds: A rigid, tender abdomen suggests peritonitis, a life-threatening complication of peritoneal dialysis requiring immediate intervention.

B. Glucose 220 mg/Dl: Elevated glucose is concerning but not immediately life-threatening compared to the other findings.

C. No dialysis for 24 hours: Missing dialysis leads to toxin accumulation, hyperkalemia, and fluid overload, all of which can be life-threatening.

D. Crackles throughout the lungs: Fluid overload can cause pulmonary edema, leading to respiratory distress. Immediate intervention is needed to prevent respiratory failure.

E. WBC 17,000 mm³: Leukocytosis suggests infection, possibly peritonitis, which requires urgent antibiotic therapy.

F. Hemoglobin 10 g/dL: Mild anemia is expected in CKD and not an emergency.

G. Potassium 7 mEq/L: Severe hyperkalemia is a medical emergency due to the risk of life-threatening cardiac arrhythmias.

H. Creatinine 3 mg/dl: Creatinine is chronically elevated in CKD and not an acute concern.

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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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Explanation

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