A nurse is caring for a client in the emergency department. Exhibits The nurse is caring for the client in the ED. The nurse understands that the client is at risk of developing which of the following complications? Select all that apply.

Rationale: A. Renal failure: The client has elevated creatinine levels (1.7 mg/dL), which suggests kidney impairment. This could be due to dehydration and osmotic diuresis associated with hyperglycemia, which is commonly seen in diabetic ketoacidosis (DKA) or hyperglycemic-hyperosmolar state (HHS). B. Hypotension: The client’s blood pressure is low (96/65 mm Hg), which can be attributed to dehydration caused by excessive urination and hyperglycemia. Hypotension can worsen as the client becomes more dehydrated, potentially progressing to shock. C. Cerebral edema: Cerebral edema is a rare but serious complication of diabetic ketoacidosis (DKA), particularly in younger patients and those with severe electrolyte imbalances. The rapid correction of hyperglycemia can cause osmotic shifts that may lead to cerebral edema. The client’s altered fluid balance increases this risk. D. Septic shock: Although the client has a history of bronchitis and pneumonia, there is no evidence of active sepsis at this time. Septic shock is characterized by signs of infection, such as fever and widespread infection leading to organ dysfunction. This client’s symptoms point more toward a metabolic complication rather than sepsis. E. Respiratory alkalosis: Respiratory alkalosis occurs when there is excessive loss of carbon dioxide due to hyperventilation. In this client, there is no indication of Kussmaul respirations to suggest respiratory alkalosis. The client is more likely to develop metabolic acidosis due to the presence of ketones and a low pH (7.30). F. Cardiac arrhythmias: Elevated potassium levels (5.5 mEq/L) and the potential for rapid fluctuations in electrolytes in a client with DKA or HHS can increase the risk of cardiac arrhythmias. Potassium imbalances hyperkalemia or hypokalemia, are closely linked to arrhythmias.