NCLEX-RN® Question of the Day: Acute kidney injury (AKI)

Today’s NCLEX-RN® Question of the Day focuses on a client diagnosed with acute kidney injury (AKI). Can you figure out the answer? Let’s find out!

The nurse is caring for a client diagnosed with acute kidney injury (AKI) who is prescribed 50% dextrose IV and 10 units of regular insulin IV bolus. Which type of electrolyte imbalance will these prescribed medications help to correct?

A. Hypernatremia

B. Hypercalcemia

C. Hypophosphatemia

D. Hyperkalemia

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The correct answer to today’s NCLEX-RN® Question is…

D. Hyperkalemia

Rationale: AKI is associated with increased serum blood urea nitrogen (BUN), creatinine, and potassium. Because hyperkalemia, or a high serum potassium level, is a life-threatening complication of AKI, the nurse should anticipate administering IV glucose and insulin to promote the movement of potassium into the cells. If hyperkalemic changes are noted on the electrocardiogram (ECG), IV calcium gluconate may also be administered to raise the cardiac excitation threshold.

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Main Takeaway

Because hyperkalemia is a life-threatening complication of AKI, the nurse should anticipate administering IV glucose and insulin to promote the movement of potassium into the cells. Following administration, the nurse should monitor the client for arrhythmias and frequently check the blood glucose level.

Incorrect Answer Explanations

A. Hypernatremia

Rationale: Hypernatremia, or a high serum sodium level, is not a common complication of AKI. Serum sodium levels may be normal or low with AKI.

B. Hypercalcemia

Rationale: Hypercalcemia, or a high serum calcium level, is not a common complication of AKI. Hypercalcemia is not treated with glucose and insulin.

C. Hypophosphatemia

Rationale: Hypophosphatemia, or a low serum phosphorus level, is not a common complication of AKI. Rather, hyperphosphatemia can occur.

References

• Lewis, S.L., Bucher, L., Heitkemper, M.M. & Harding, M.M. (2017). Medical-surgical nursing: Assessment and management of clinical problems (10th ed.). St. Louis, MO: Elsevier.

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