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A 5-year-old is admitted to the hospital with DKA. To prevent cardiac arrhythmias, which lab result should the nurse monitor closely?

Explanation

• During ketoacidosis, potassium serum levels rise, causing hyperkalemia. Also, potassium needs close monitoring when insulin is given, because this pushes the K+ back into the cells, causing a drop in serum levels. Potassium imbalances can cause harmful cardiac arrhythmias.

• The classic theory is that extracellular H+ enters the cells and is exchanged for intracellular K+ during acidosis, leading to the hyperkalemia. A newer theory suggests that elevated serum potassium may be due to the compromised renal function secondary to the dehydration from in DKA.

• Incorrect: Changes in sodium, calcium, and chloride generally do not cause arrhythmias.

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