The patient has a potassium level of 5.9 mEq/L. The nurse is ...

[s.tung]

The patient has a potassium level of 5.9 mEq/L. The nurse is administering glucose and insulin. The patient's wife says, He doesn't have diabetes, why is he getting insulin? What is the best response by the nurse?
 
  1. Insulin will cause his extra potassium to go into his cells and lower the blood level.
  2. Insulin lowers his blood sugar levels and this is how the extra potassium is excreted.
  3. Insulin is safer than giving laxatives such as Kayexalate.
  4. Insulin will help his kidneys excrete the extra potassium.

Question 2

The patient is dehydrated, but has a normal blood pressure. The new medical intern orders normal serum albumin intravenously (IV) for this patient. What is the best evaluation by the nurse regarding this order?
 
  1. It is a correct and valid order.
  2. The intern should have ordered 5 dextrose in normal saline.
  3. The intern should have ordered 0.45 NaCl.
  4. The intern should have ordered 0.9 NaCl.

[cascooper22]

Answer to Question 1

Correct Answer: 1
Rationale: Serum potassium levels may be temporarily lowered by administering glucose and insulin, which cause potassium to leave the extracellular fluid and enter cells. Giving insulin to decrease serum potassium levels is not considered a safer method than giving Kayexalate. Insulin does not promote renal excretion of potassium. Serum potassium is lowered by entering the cells; this is not controlled by serum glucose.

Answer to Question 2

Correct Answer: 3
Rationale: 0.45 NaCl is a hypotonic solution. This will cause fluid to shift from plasma to the tissues and cells in the intravascular compartment. Hypotonic solutions are indicated for patients who are dehydrated with normal blood pressure. Normal serum albumin is a hypertonic solution; the patient requires a hypotonic solution 5 dextrose in normal saline is a hypertonic solution; the patient requires a hypotonic solution. 0.9 NaCl is an isotonic solution, the patient requires a hypotonic solution.

[s.tung]

TYSM

[rachel]

Gracias!