Change the second i.v. solution to dextrose 5% in water.-rationale: the nurse should question the physicians order to change the second i.v. solution to dextrose 5% in water. the client should receive normal saline solution through the second i.v. site until his blood glucose level reaches 250 mg/dl. the client should receive a fluid bolus of 500 ml of normal saline solution. the clients urine output is low and his specific gravity is high, which reveals dehydration. the nurse should expect to hold the insulin infusion for 30 minutes until the potassium replacement has been initiated. insulin administration causes potassium to enter the cells, which further lowers the serum potassium level. further lowering the serum potassium level places the client at risk for life-threatening cardiac arrhythmias.client needs category: physiological integrityclient needs subcategory: reduction of risk potentialcognitive level: analysisreference: smeltzer, s.c., et al. brunner and suddarths textbook of medical surgical-nursing, 11th ed. philadelphia: lippincott williams & wilkins, 2008, p. 1414.
