A nurse is caring for a client in the emergency department. 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

A. Cerebral edema: This client is experiencing diabetic ketoacidosis (DKA), as evidenced by markedly elevated blood glucose, low pH, and positive urine ketones. During treatment of DKA, rapid shifts in serum glucose and osmolality, especially with aggressive fluid or insulin therapy, can lead to cerebral edema. This is a known and serious complication of DKA, making cerebral edema a significant risk for this client. B. Hypotension: The client shows clear signs of dehydration, including tachycardia, low blood pressure, frequent urination, intense thirst, and skin tenting. Osmotic diuresis caused by severe hyperglycemia leads to significant fluid volume loss, placing the client at high risk for hypotension and hypovolemic shock if not promptly treated with IV fluids. C. Cardiac arrhythmias: The client’s potassium level is elevated at 5.5 mEq/L. In DKA, potassium shifts out of cells due to acidosis, increasing the risk for dangerous cardiac arrhythmias. Additionally, potassium levels can rapidly drop once insulin therapy is initiated, further increasing the risk for rhythm disturbances. Continuous cardiac monitoring is essential. D. Respiratory alkalosis: The client’s pH is 7.30, indicating metabolic acidosis, not respiratory alkalosis. Clients in DKA may develop deep, rapid respirations as a compensatory response, but this does not indicate respiratory alkalosis. E. Septic shock: Although the client recently had bronchitis and pneumonia, there is no evidence of active sepsis at this time. The client is afebrile, alert, and has stable oxygenation. While infection can precipitate DKA, septic shock is not currently supported by the assessment data. F. Renal failure: The client has elevated BUN and creatinine levels, indicating impaired renal perfusion likely due to dehydration. Prolonged hypotension and volume depletion can progress to acute kidney injury. Therefore, this client is at risk for renal failure if fluid deficits are not corrected promptly.