Discuss the relationship between decreased urine output and elevation of serum BUN

A 20-year-old woman was admitted to the hospital following a car-train collision. Discuss the relationship between decreased urine output and elevation of serum BUN, creatinine, and potassium levels.•

She appeared to have internal injuries and was thought to be hemorrhaging.  She remained hypotensive throughout emergency surgery for the removal of a ruptured spleen.

Following surgery and blood transfusions, her condition remained stable for 4 days.  Urine output then began decreasing, and BUN, creatinine, and serum potassium levels showed elevation.

•. The urinary output continued to decrease and the patient became oliguric.  It was determined that she had developed acute renal failure and should be placed on hemodialysis for 6-hour periods.

This procedure was tolerated well, but the elevation of serum potassium levels continued to be a major problem during dialysis.  What other options are available for the treatment of hyperkalemia
3.•The physician ordered 250 ml D5W with 10 units of insulin to be given IV immediately.  What is the action of this medication?