A nurse reviews the laboratory results of a client who is ...

[jerry coleman]

A nurse reviews the laboratory results of a client who is receiving intravenous insulin. Which should alert the nurse to intervene immediately?
 
  a. Serum chloride level of 98 mmol/L
  b. Serum calcium level of 8.8 mg/dL
  c. Serum sodium level of 132 mmol/L
  d. Serum potassium level of 2.5 mmol/L

Question 2

A nurse assesses a client who has diabetes mellitus and notes the client is awake and alert, but shaky, diaphoretic, and weak. Five minutes after administering a half-cup of orange juice, the client's clinical manifestations have not changed.
 
  Which action should the nurse take next?
  a.
  Administer another half-cup of orange juice.
  b.
  Administer a half-ampule of dextrose 50 intravenously.
  c.
  Administer 10 units of regular insulin subcutaneously.
  d.
  Administer 1 mg of glucagon intramuscularly.

[hramirez205]

Answer to Question 1

ANS: D
Insulin activates the sodium-potassium ATPase pump, increasing the movement of potassium from the extracellular fluid into the intracellular fluid, resulting in hypokalemia. In hyperglycemia, hypokalemia can also result from excessive urine loss of potassium. The chloride level is normal. The calcium and sodium levels are slightly low, but this would not be related to hyperglycemia and insulin administration.

Answer to Question 2

ANS: A
This client is experiencing mild hypoglycemia. For mild hypoglycemic manifestations, the nurse should administer oral glucose in the form of orange juice. If the symptoms do not resolve immediately, the treatment should be repeated. The client does not need intravenous dextrose, insulin, or glucagon.

[jerry coleman]

Thanks for the timely response, appreciate it

[cassie_ragen]

Excellent