The nurse monitors the blood glucose levels of a patient being treated with insulin for diabetic ketoacidosis to ensure glucose levels decline at the rate of 50-70 mg/dL/hour because:
1. When blood glucose drops rapidly fluids shift out of the cell, which increases dehydration, causing severe hypovolemic shock.
2. When blood glucose drops rapidly severe damage to the brain results from metabolic alkalosis.
3. A rapid drop in blood glucose can result in hypokalemia, causing life-threatening arrhythmias.
4. A rapid drop in blood glucose can result in formation of thromboses as a result of dehydration.
3
Rationale 1: Dehydration is caused by hyperglycemia and osmotic diuresis rather than the infusion of insulin.
Rationale 2: Rapidly dropping glucose does not result in metabolic alkalosis.
Rationale 3: A rapid shift in potassium from the serum into the intracellular compartment may result because IV insulin facilitates the transport of glucose into the cells. This rapid electrolyte shift can cause life-threatening cardiac arrhythmias as a result of hypokalemia.
Rationale 4: Rapidly dropping glucose does not cause the formation of thromboses.
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