The nurse is caring for a patient admitted with advanced liver disease. Which laboratory result(s) would the nurse expect? Select all that apply.

Choice A reason: Placing the patient on a cardiac monitor immediately is crucial due to the elevated potassium level (6.9), which can cause life-threatening cardiac arrhythmias. Continuous cardiac monitoring allows for the early detection and prompt management of any arrhythmias that may occur.

Choice B reason: Weighing the patient immediately is important for assessing fluid status and for calculating appropriate medication dosages. In patients with acute kidney injury, monitoring fluid balance is critical to prevent fluid overload and ensure accurate treatment.

Choice C reason: Anticipating a fluid bolus is not appropriate for this patient. Fluid overload can exacerbate kidney injury and worsen the patient's condition. Fluid management should be carefully tailored based on the patient's overall clinical status and needs.

Choice D reason: Asking to have the laboratory redraw the blood specimen is unnecessary if the initial results are accurate and timely. The focus should be on addressing the critical findings, such as hyperkalemia, rather than retesting.

Choice E reason: Anticipating an order for a diuretic might be considered, but it is not the immediate priority. Diuretics may be useful in managing fluid overload but do not directly address the immediate life-threatening hyperkalemia.

Choice F reason: Preparing to administer IV insulin and dextrose as ordered is essential for treating hyperkalemia. Insulin helps to shift potassium into cells, thereby lowering the serum potassium level. Dextrose is given concurrently to prevent hypoglycemia caused by insulin administration.

Choice G reason: Administering Kayexalate (sodium polystyrene) as ordered is important for removing excess potassium from the body. Kayexalate works by exchanging sodium for potassium in the intestines, promoting the excretion of potassium in the stool.

Choice A reason: Monitoring serum potassium and sodium levels is important in many clinical situations, but it is not the primary concern when administering Vancomycin. Vancomycin can cause nephrotoxicity, which is best assessed by monitoring kidney function indicators such as serum creatinine and blood urea nitrogen levels.

Choice B reason: Temperature and blood pressure should be monitored regularly in patients receiving IV medications, especially antibiotics, to detect signs of infection or adverse reactions. However, the specific priority when administering Vancomycin is monitoring for nephrotoxicity, which is more accurately assessed through serum creatinine and BUN levels.

Choice C reason: Daily weight and edema monitoring are important for assessing fluid balance and potential heart or kidney issues. While useful, these are not the primary markers for detecting complications related to Vancomycin administration.

Choice D reason: Serum creatinine and blood urea nitrogen levels are critical indicators of kidney function. Vancomycin can cause nephrotoxicity, so monitoring these levels helps detect any signs of kidney injury early, ensuring appropriate adjustments to the medication regimen to prevent further damage.