A 38-year-old man has come into the urgent care center with severe hip pain after falling from a ladder at work. He says he has taken several pain pills over the past few hours but cannot remember how many he has taken. He hands the nurse an empty bottle of acetaminophen (Tylenol). The nurse is aware that the most serious toxic effect of acute acetaminophen overdose is which condition?

Choice A reason: This statement is false. Asking the patient about home insulin doses is not the action that the nurse should take first. Insulin is a hormone that lowers the blood glucose level and can also lower the blood potassium level by driving potassium into the cells. However, this is not the primary cause of hypokalemia, or low blood potassium level, which can be due to other factors such as diuretics, vomiting, diarrhea, or alkalosis.

Choice B reason: This statement is true. Administering IV potassium supplements is the action that the nurse should take first. Potassium is an electrolyte that is essential for the normal function of the heart, muscles, and nerves. Hypokalemia can cause cardiac arrhythmias, muscle weakness, and paralysis. IV potassium supplements can restore the blood potassium level and prevent life-threatening complications.

Choice C reason: This statement is false. Placing the patient on a cardiac monitor is not the action that the nurse should take first. A cardiac monitor is a device that records the electrical activity of the heart and can detect any abnormal rhythms or conduction problems. It is a useful tool for monitoring the patient's cardiac status, but it does not treat the underlying cause of hypokalemia.

Choice D reason: This statement is false. Starting an insulin infusion at 0.1 units/kg/h is not the action that the nurse should take first. Insulin infusion is a method of delivering insulin continuously through a pump or a catheter. It is used for patients with diabetes who need tight glucose control. It can also lower the blood potassium level by driving potassium into the cells. However, this is not t

Choice A reason: This statement is false. A serum potassium level of 5.6 mEq/L is not a common side effect of furosemide. This value indicates hyperkalemia, or high blood potassium level, which can cause cardiac arrhythmias and muscle weakness. Furosemide is a loop diuretic that causes potassium loss, not retention.

Choice B reason: This statement is false. A serum sodium level of 142 mEq/L is not a common side effect of furosemide. This value is within the normal range of 135-145 mEq/L and does not indicate any problem with sodium balance. Furosemide is a loop diuretic that causes sodium loss, but it is usually compensated by the renin-angiotensin-aldosterone system.

Choice C reason: This statement is false. A serum sodium level of 138 mEq/L is not a common side effect of furosemide. This value is within the normal range of 135-145 mEq/L and does not indicate any problem with sodium balance. Furosemide is a loop diuretic that causes sodium loss, but it is usually compensated by the renin-angiotensin-aldosterone system.

Choice D reason: This statement is true. A serum potassium level of 2.8 mEq/L is a common side effect of furosemide. This value indicates hypokalemia, or low blood potassium level, which can cause cardiac arrhythmias, muscle weakness, and metabolic alkalosis. Furosemide is a loop diuretic that inhibits the reabsorption of sodium and potassium in the ascending loop of Henle, leading to potassium loss in the urine.