The nurse is caring for a patient with acute kidney injury. The nurse would expect that IV regular insulin and glucose, sodium bicarbonate, and IV calcium gluconate will be used to treat what complication of acute kidney injury?

A. Hyperkalemia: Acute kidney injury reduces the kidneys’ ability to excrete potassium, leading to dangerous elevations in serum potassium levels. IV regular insulin with glucose shifts potassium intracellularly by stimulating the sodium–potassium ATPase pump, while sodium bicarbonate promotes intracellular potassium movement in acidotic states. IV calcium gluconate stabilizes the cardiac membrane, reducing the risk of life-threatening arrhythmias. B. Hyperglycemia: Although insulin lowers blood glucose levels, in this context it is administered primarily to shift potassium into cells rather than to treat elevated glucose. Sodium bicarbonate and calcium gluconate do not play roles in managing hyperglycemia. The combination specifically targets the cardiac and metabolic consequences of elevated potassium. C. Hypoglycemia: Hypoglycemia is treated with glucose administration, not insulin. Giving insulin in a hypoglycemic state would further lower blood glucose and worsen neurologic compromise. The addition of calcium gluconate and sodium bicarbonate would not be indicated in isolated low blood sugar. D. Hypocalcemia: Calcium gluconate is used to treat symptomatic hypocalcemia; however, in acute kidney injury, it is more commonly given to stabilize the myocardium during hyperkalemia rather than to correct calcium levels directly. Insulin with glucose and sodium bicarbonate are not treatments for hypocalcemia.