Question

A patient is admitted with diabetes mellitus, malnutrition, and cellulitis. The patient's potassium level is 5.6 mEq/L. The nurse understands that what could be contributing factors for this laboratory result (select all that apply)?

a. The level may be increased as a result of dehydration that accompanies hyperglycemia.
b. The patient may be excreting extra sodium and retaining potassium because of malnutrition.
c. The level is consistent with renal insufficiency that can develop with renal nephropathy.
d. The level may be raised as a result of metabolic ketoacidosis caused by hyperglycemia.
e. This level demonstrates adequate treatment of the cellulitis and effective serum glucose control.

Answer 1

The patient's high potassium level can be attributed to dehydration from hyperglycemia, potential renal insufficiency due to diabetic nephropathy, and metabolic ketoacidosis caused by hyperglycemia. These conditions are known to affect potassium homeostasis and are consistent with what is observed in diabetic patients.

Step-by-step explanation:

The nurse should consider several factors that could contribute to the patient's elevated potassium level (hyperkalemia) of 5.6 mEq/L in the context of diabetes mellitus, malnutrition, and cellulitis:

• a. Dehydration from Hyperglycemia: The potassium level may be increased due to dehydration that accompanies hyperglycemia. In diabetes mellitus, hyperglycemia can cause the kidneys to produce a high volume of urine, leading to dehydration, which can concentrate potassium in the blood.
• c. Renal Insufficiency: The potassium level could be indicative of renal insufficiency, potentially associated with diabetic nephropathy. High glucose levels can damage the kidneys over time, affecting their ability to filter potassium adequately.
• d. Metabolic Ketoacidosis: The elevated potassium level may be a result of metabolic ketoacidosis caused by hyperglycemia. As the body breaks down fats instead of glucose for energy, the production of ketone bodies increases, leading to acidic blood and causing potassium to move out of the cells into the bloodstream.

These factors are consistent with conditions that affect potassium levels in diabetic patients. Options b and e do not support the laboratory result, as malnutrition typically leads to potassium loss, and cellulitis treatment and glucose control are not directly linked to potassium levels.