RN Nursing · Electrolyte Imbalances · Practice question
A patient with hyperkalemia receives insulin and dextrose. Which findings indicate therapy effectiveness? Select all that apply.
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✓
Dysrhythmias decrease
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U Wave appears in the EKG
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✓
Peaked T waves resolve
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✓
Serum potassium decreases
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Peaked T waves worsen
Answer & explanation
Correct: Dysrhythmias decrease · Peaked T waves resolve · Serum potassium decreases
Insulin drives potassium from the extracellular space into cells, and dextrose is co-administered to prevent hypoglycemia. Successful treatment of hyperkalemia is evidenced by a fall in serum potassium toward the normal range, resolution of the characteristic peaked T waves on ECG, and reduction of dysrhythmias that are driven by the elevated potassium level. These three findings confirm that potassium is shifting intracellularly and myocardial membrane stability is being restored. A U wave appearing on the ECG is associated with hypokalemia, not hyperkalemia, so its appearance would actually suggest overcorrection into a low-potassium state — a complication rather than a sign of appropriate response. Worsening peaked T waves would indicate that therapy is failing and hyperkalemia is persisting or deteriorating, which is the opposite of an effective outcome. The nurse must monitor serum potassium levels and cardiac rhythm closely during and after insulin-dextrose infusion to confirm effectiveness and detect over- or under-treatment.
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