A nurse is caring for a client who has a hyperkalemia and is receiving insulin therapy. Which of the following should the nurse recognize as an adverse outcome?
Serum potassium 4.8 mEq/L (3.5 to 5.0 mEq/L)
Serum sodium 138 mEq/L (136 to 145 mEq/L)
Calcium level of 10.0 mg/dL (9.0 to 10.5 mg/dL)
Serum glucose 58 mg/dL (74 to 106 mg/dL)
The Correct Answer is D
A. Serum potassium 4.8 mEq/L (3.5 to 5.0 mEq/L): A normal potassium level suggests effective treatment of hyperkalemia.
B. Serum sodium 138 mEq/L (136 to 145 mEq/L): This is within the normal sodium range and unrelated to the adverse effects of insulin therapy.
C. Calcium level of 10.0 mg/dL (9.0 to 10.5 mg/dL): This is within the normal calcium range, unaffected by insulin therapy for hyperkalemia.
D. Serum glucose 58 mg/dL (74 to 106 mg/dL): Hypoglycemia is a potential adverse effect of insulin therapy because insulin drives glucose into cells, lowering blood sugar.
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Related Questions
Correct Answer is D
Explanation
A. "You are retaining a lot of sodium and potassium, and that causes you to gain water weight.": SIADH involves dilutional hyponatremia, not retention of sodium and potassium.
B. "Your kidneys are not working correctly, so they can't get rid of extra water from your system.": SIADH results from excessive secretion of antidiuretic hormone (ADH), not kidney dysfunction.
C. "The syndrome causes an increase in appetite. As soon as you are effectively treated, the weight should drop back to normal for you.": SIADH causes water retention, not increased appetite.
D. "You have too much of a hormone in your system that causes you to retain water. The extra 10 pounds is likely water weight.": This accurately explains that excess ADH leads to water retention, causing weight gain.
Correct Answer is C
Explanation
A. "I should inject my insulin detemir 30 min before a meal to lower my blood sugar.": Insulin detemir is a long-acting insulin that provides basal glucose control and is not meal-dependent.
B. "If my blood sugar is high, I can mix a dose of regular insulin with my insulin detemir.": Insulin detemir should not be mixed with any other insulin in the same syringe.
C. "I can inject my insulin detemir in the evening before bedtime.": Insulin detemir is commonly administered once daily, and evening administration helps maintain stable glucose levels overnight.
D. "I don't have to worry about hypoglycemia while taking insulin detemir.": While the risk of hypoglycemia is lower with detemir than with some other insulins, it is still possible, particularly if meals are missed or doses are mismanaged.
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