A physician orders regular insulin 10 units I.V. along with 50 ml of dextrose 50% for a client with acute renal failure newly admitted to the critical care unit. What electrolyte imbalance is this client most likely experiencing?

Hypernatremia

Hyperglycemia

Hypercalcemia

Hyperkalemia

Answer and Explanation

The Correct Answer is B

A. Hypernatremia: This condition involves elevated sodium levels, which is not directly addressed by the insulin and dextrose order.
B. Hyperglycemia: While dextrose can exacerbate hyperglycemia, the order of insulin and dextrose is not for managing hyperglycemia but for another purpose.
C. Hypercalcemia: This condition involves elevated calcium levels and is not related to the use of insulin and dextrose.
D. Hyperkalemia: The administration of regular insulin with dextrose is often used to manage hyperkalemia. Insulin helps shift potassium into cells, while dextrose prevents hypoglycemia resulting from the insulin.

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Correct Answer is D

Explanation

A. Poorly controlled pain, moves all extremities, reports continued nausea: Poorly controlled pain and nausea are not ideal for discharge, as they indicate the patient might need further monitoring and management.
B. 2-hour total urinary output of 30 mL, pulse oximetry 94% on 3L oxygen, turning from side to side: Low urinary output and low oxygen saturation indicate potential complications that require further assessment and treatment.
C. Afebrile, adventitious breath sounds, responds to painful stimuli: Responding to painful stimuli and adventitious breath sounds suggest the patient may still be experiencing complications and is not ready for discharge.
D. SaO2 of 95%, vital signs stable for last 30 minutes, active gag reflex: This response indicates stable oxygen saturation, stable vital signs, and an active gag reflex, suggesting the patient is ready for discharge from the PACU.

A. "Maybe you are more depressed than you realize. Would you like to talk about it?" B. "Depression is often a factor in pain. Treating the depression helps treat the pain." C. "Why don't you try it for a while, and if you don't feel better, you can ask your doctor if you can stop it?" D. "Antidepressants are sometimes used to manage the type of nerve pain you are experiencing."

Correct Answer is D

Explanation

A. "Maybe you are more depressed than you realize. Would you like to talk about it?": This response may dismiss the client's concerns and assumes depression without explaining the rationale for the medication.
B. "Depression is often a factor in pain. Treating the depression helps treat the pain.": While this may be true, it might not address the specific rationale for the antidepressant in managing nerve pain.
C. "Why don't you try it for a while, and if you don't feel better, you can ask your doctor if you can stop it?": This response lacks an explanation and may not address the client’s concerns about why the medication was prescribed.
D. "Antidepressants are sometimes used to manage the type of nerve pain you are experiencing.": This is the correct choice. It directly addresses the use of antidepressants for managing neuropathic pain, which can be effective even in the absence of depression.

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A physician orders regular insulin 10 units I.V. along with 50 ml of dextrose 50% for a client with acute renal failure newly admitted to the critical care unit. What electrolyte imbalance is this client most likely experiencing?

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Explanation

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Explanation

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