The nurse is evaluating clients in the emergency department (ED) for pending mental health admissions. Which client will be admitted for involuntary hospitalization?

Choice A reason: Defensive coping involves mechanisms like denial to manage stress, not personal emotional connections to a patient. The nurse’s sadness reflects personal feelings, not a defense against anxiety. This term does not apply to the nurse’s emotional response to the patient’s condition or perceived helplessness.

Choice B reason: Countertransference occurs when a nurse projects personal feelings, like sadness, onto a patient due to similarities with personal experiences (e.g., grandparents). This emotional response can influence care if not managed, as it stems from the nurse’s unresolved feelings, making it the accurate description of the situation.

Choice C reason: Transference involves the patient projecting feelings onto the nurse, not the nurse’s emotions about the patient. The scenario describes the nurse’s feelings, not the patient’s, making transference inapplicable. The nurse’s sadness reflects personal emotional involvement, not a patient-driven dynamic.

Choice D reason: Catastrophic reaction refers to a patient’s exaggerated emotional response to stress, often in dementia, not the nurse’s feelings. The nurse’s sadness is a personal emotional reaction, not a patient behavior, making this term irrelevant to the described situation of the nurse’s emotional reflection.

Choice A reason: Hypoglycemia involves low blood glucose, causing symptoms like shakiness or confusion, not muscle weakness or arrhythmias. Hypertonic glucose and insulin would worsen hypoglycemia by increasing glucose uptake, and sodium bicarbonate is irrelevant. These symptoms and treatments align with hyperkalemia, not low glucose levels, in renal failure.

Choice B reason: Hyperkalemia, common in acute renal failure due to impaired potassium excretion, causes muscle weakness and cardiac arrhythmias by altering membrane potentials. Hypertonic glucose and insulin drive potassium into cells, while sodium bicarbonate corrects acidosis, stabilizing cardiac membranes, making this the targeted complication for the prescribed treatment.

Choice C reason: Hypernatremia (high sodium) causes neurological symptoms like confusion, not muscle weakness or arrhythmias. The prescribed treatments do not address sodium levels; insulin and glucose manage potassium, and bicarbonate corrects acidosis. Hypernatremia is not a primary concern in acute renal failure with these symptoms.

Choice D reason: Hypokalemia (low potassium) causes muscle weakness and arrhythmias but is rare in acute renal failure, where hyperkalemia is typical due to reduced excretion. The prescribed treatments aim to lower potassium, not increase it, making hypokalemia an incorrect target for this therapy in the context of renal failure.