A patient with acute kidney injury has a potassium level of 6.9 mg/dL.The patient has had no urine output in the past 4 hours despite administration of Lasix 40 mg intravenous push.To correct the hyperkalemia the patient is given 50 mL of 50% dextrose in water and 10 U of regular insulin intravenous push.A repeat potassium level 2 hours later shows a potassium level of 4.5 mg/dL.What order would the nurse expect now?

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Acute hyperkalemia can be treated temporarily by intravenous (IV)administration of insulin and glucose.An infusion of 50 mL of 50% dextrose accompanied by 10 units of regular insulin forces potassium out of the serum and into the cells.However,the potassium was not eliminated from the body; it was simply shifted intracellularly.Soon the potassium will return to the bloodstream,and the Kayexalate will help permanently remove it from the body.Lasix is not expected to work in the presence of anuria.The patient's vital signs do not support hypovolemia.In the presence of anuria,a large fluid infusion can precipitate acute heart failure.

A Patient with Acute Kidney Injury Has a Potassium Level