What would the nurse assess before beginning insulin therapy in a patient with hyperglycemic hyperosmolar nonketotic syndrome (HHNS)?
1. Sodium level (Na+)
2. Previous history of cardiac dysrhythmias
3. Potassium level (K+)
4. Arterial blood gas results
3
Rationale 1: This laboratory value does not need to be specifically assessed before starting insulin therapy.
Rationale 2: This does not need to be specifically assessed before starting insulin therapy.
Rationale 3: Potassium levels need to be monitored before insulin is given to avoid hypokalemia from developing because insulin facilitates intracellular transport of glucose and potassium. The rapid shift of the K+ could leave the serum potassium levels dangerously low.
Rationale 4: This does not need to be specifically assessed before starting insulin therapy.
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