The nurse misreads a blood glucose result as 210 mg/dL instead of 120 mg/dL on a patient with type 1 diabetes mellitus and gives sliding scale regular insulin. The nurse realizes the mistake 45 minutes later. What is the nurse’s priority action?

Choice A reason: Chloride levels are less critical in cirrhosis compared to sodium. Chloride imbalances may occur secondary to diuretic use or acid-base disturbances, but they do not directly drive major complications like ascites or edema. Monitoring is less urgent, as chloride fluctuations are typically managed indirectly through fluid and electrolyte balance.

Choice B reason: Calcium levels are not the primary concern in cirrhosis. Hypocalcemia may occur due to malnutrition or vitamin D deficiency from liver dysfunction, but it is less immediate than sodium imbalances. Calcium affects bone health and muscle function but does not directly impact acute cirrhosis complications like ascites.

Choice C reason: Sodium is critical to monitor in cirrhosis due to its role in fluid balance. Hyponatremia, common in advanced cirrhosis, results from impaired water excretion and portal hypertension, contributing to ascites and edema. Dilutional hyponatremia can worsen encephalopathy or indicate decompensation, requiring urgent management to stabilize the patient.

Choice D reason: Potassium monitoring is important, especially with diuretic use in cirrhosis, as hypokalemia or hyperkalemia can occur. However, sodium imbalances more directly influence fluid retention and ascites, making it a higher priority. Potassium affects cardiac and muscle function but is secondary to sodium in acute cirrhosis management.

Choice A reason: Nausea and vomiting are common in acute pancreatitis due to pancreatic inflammation causing gastrointestinal irritation and slowed gastric emptying. While uncomfortable and requiring management, they are expected symptoms and less immediately life-threatening than cardiovascular instability, as they do not directly indicate systemic complications like shock.

Choice B reason: Low-grade fever may occur in acute pancreatitis due to inflammation or early infection. It is concerning but not immediately critical unless persistent or high-grade, as it does not directly indicate systemic decompensation or organ failure, unlike cardiovascular changes that suggest hemodynamic instability.

Choice C reason: Tachycardia is highly concerning in acute pancreatitis, as it may indicate hypovolemia, shock, or systemic inflammatory response syndrome (SIRS) from pancreatic necrosis or fluid sequestration. Rapid heart rate reflects cardiovascular stress, requiring urgent intervention to stabilize circulation and prevent multi-organ failure, making it the most critical finding.

Choice D reason: Absent bowel sounds suggest ileus, a common complication of acute pancreatitis due to inflammation affecting gastrointestinal motility. While significant, it is less urgent than tachycardia, as it does not immediately threaten hemodynamic stability or indicate systemic complications like shock or organ failure, requiring supportive care.