The client with hyperkalemia is receiving 100 mL of dextrose 20% in water with 20 units of regular insulin. The client is slightly confused, has weaker handgrasps, and is pale and swea-ty. What is the nurse's best first action?
A. Notify the emergency team.
B. Apply oxygen by mask or nasal cannula.
C. Switch the IV solution to dextrose 5% in water.
D. Prepare to administer potassium chloride by IV push.
C
Intravenous fluids containing insulin place the client at risk for hypoglycemia as well as hypoka-lemia. The client's clinical manifestations indicate both hypoglycemia and hypokalemia. The hypoglycemia can be life-threatening. Stopping the current IV solution but maintaining IV access is critical. Although potassium may be given as a small infusion (100 to 150 mL) of IV fluid, it is not given by IV push.
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