A nurse is preparing to administer medications to a client who has pericarditis. Which of the following medications should the nurse anticipate to his client? (Select All that Apply)

The correct answer is a) Serum potassium levels.

Choice A reason:

Serum potassium levels are crucial to monitor in clients with hypervolemia, ketoacidosis, and metabolic acidosis. Potassium imbalances are common in these conditions due to shifts between intracellular and extracellular compartments. In diabetic ketoacidosis (DKA), for example, insulin deficiency and acidosis cause potassium to move out of cells, leading to hyperkalemia. However, once treatment with insulin begins, potassium shifts back into cells, which can cause hypokalemia. Both hyperkalemia and hypokalemia can have serious cardiac implications, making it essential to monitor and manage potassium levels closely.

Choice B reason:

Serum calcium levels are important for overall health, but they are not the primary concern in the context of hypervolemia, ketoacidosis, and metabolic acidosis. While calcium imbalances can occur, they are less common and less immediately life-threatening compared to potassium imbalances. Monitoring calcium is still necessary, but it does not require the same level of immediate intervention.

Choice C reason:

Serum sodium levels are also important to monitor, especially in conditions like hypervolemia where fluid balance is disrupted. However, sodium imbalances are typically managed through fluid management and do not pose the same immediate risk as potassium imbalances in the context of ketoacidosis and metabolic acidosis. Hyponatremia or hypernatremia can cause neurological symptoms, but these are generally less acute compared to the cardiac risks associated with potassium imbalances.

Choice D reason:

Blood urea nitrogen (BUN) levels provide information about kidney function and hydration status. Elevated BUN can indicate dehydration or renal impairment, which are relevant in the context of hypervolemia and ketoacidosis. However, BUN levels do not require the same level of immediate intervention as potassium levels. Monitoring BUN is important for overall management but is not the primary concern in acute settings.

Choice A Reason:

The adrenal glands play a crucial role in responding to low blood glucose levels by releasing epinephrine (adrenaline) and norepinephrine. These hormones help to increase blood glucose levels by stimulating glycogenolysis (the breakdown of glycogen to glucose) and gluconeogenesis (the production of glucose from non-carbohydrate sources) in the liver. This response is part of the body’s fight-or-flight mechanism, which ensures that sufficient glucose is available for immediate energy needs.

Choice B Reason:

The liver does not release glucagon; rather, it responds to glucagon, which is released by the pancreas. Glucagon stimulates the liver to convert stored glycogen into glucose (glycogenolysis) and to produce glucose from non-carbohydrate sources (gluconeogenesis). This process helps to raise blood glucose levels when they are low.

Choice C Reason:

Glycogenesis is the process of converting glucose into glycogen for storage, and it occurs primarily in the liver and muscle cells, not in the pancreas. The pancreas releases insulin to promote glycogenesis when blood glucose levels are high, but it does not perform glycogenesis itself.

Choice D Reason:

The brain primarily uses glucose for energy and does not switch to using protein unless glucose levels are extremely low and prolonged. In such cases, the brain can use ketone bodies derived from fat as an alternative energy source. Protein is not a primary energy source for the brain under normal conditions.