Certified Post Anesthesia Nurse (CPAN) Practice Exam

In post-operative patients with end-stage renal disease, what complication is IV glucose and insulin administered to correct?

1. Hyponatremia

2. Hypokalemia

3. Hypernatremia

4. Hyperkalemia

The correct answer is: Hyperkalemia

The administration of intravenous glucose and insulin is primarily aimed at correcting hyperkalemia in post-operative patients, particularly those with end-stage renal disease. Hyperkalemia, which is characterized by elevated levels of potassium in the blood, can pose serious risks, including cardiac arrhythmias and other cardiovascular complications. In cases of hyperkalemia, insulin facilitates the transport of potassium from the extracellular space back into the cells, thus lowering serum potassium levels. The accompanying administration of glucose is crucial because it helps prevent hypoglycemia that can occur due to the insulin's action. Patients with end-stage renal disease often have difficulty excreting potassium, making hyperkalemia a common complication. The use of insulin therapy in conjunction with glucose serves as a rapid and effective method to manage this condition in a post-operative setting where patients may already be at risk for increased potassium levels due to impaired renal function. Other conditions, such as hyponatremia, hypokalemia, and hypernatremia, are managed with different interventions, highlighting the specific utility of glucose and insulin in the context of hyperkalemia management.