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 C

Explanation

A. Vomiting: Vomiting is a common symptom associated with metabolic acidosis but is not a compensatory mechanism. It can lead to further electrolyte imbalances and dehydration.
B. Tachycardia: Tachycardia can occur as a response to acidosis but is not a direct compensatory mechanism for metabolic acidosis.
C. Deep rapid breathing: This is the correct choice. Deep rapid breathing, or Kussmaul respirations, is a compensatory mechanism for metabolic acidosis. It helps to expel carbon dioxide, thereby reducing acidity in the blood.
D. Watery diarrhea: Diarrhea can contribute to electrolyte imbalances and may exacerbate acidosis but is not a compensatory response by the body.

A. Intraosseous line B. Intrathecal catheter C. Peripheral intravenous line D. Subcutaneous implantable port E. Subcutaneous implantable port

Correct Answer is D

Explanation

A. Intraosseous line: Intraosseous lines are used for emergency situations when peripheral access is not available, and are not suitable for long-term chemotherapy administration due to the risk of complications and discomfort.
B. Intrathecal catheter: Intrathecal catheters are used for delivering medication directly into the spinal canal. They are not suitable for systemic chemotherapy administration, which requires vascular access.
C. Peripheral intravenous line: Peripheral intravenous lines are typically used for short-term treatments. They are not ideal for long-term chemotherapy because they need frequent replacement, and the veins can become damaged from prolonged use of chemotherapeutic agents.
D. Subcutaneous implantable port: A subcutaneous implantable port is the best option for long-term chemotherapy. It is implanted under the skin, reducing the risk of infection, and provides a stable and reliable access point for repeated treatments over several months.

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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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