A 65-year-old patient with type 2 diabetes has a urinary tract infection (UTI). The unlicensed assistive personnel (UAP) reported to the nurse that the patient's blood glucose is 642 mg/dL and the patient is hard to arouse. When the nurse assesses the urine, there are no ketones present.
What collaborative care should the nurse expect for this patient?
Administer IV fluids rapidly to correct dehydration.
Routine insulin therapy and exercise
Cardiac monitoring to detect potassium changes
Administer a different antibiotic for the UTI.
The Correct Answer is A
Choice A rationale: This patient is likely experiencing hyperosmolar hyperglycemic state (HHS). Rapid administration of IV fluids is crucial to correct severe dehydration associated with HHS.
Choice B rationale: Routine insulin therapy and exercise might be components of diabetes management but wouldn't directly address the immediate concern of severe dehydration and high blood glucose.
Choice C rationale: Cardiac monitoring for potassium changes might be necessary but isn't the primary immediate intervention for HHS.
Choice D rationale: Administering a different antibiotic for the UTI is incorrect, because there is no evidence that the current antibiotic is ineffective or causing adverse effects. The UTI may have triggered the HHS, but it is not the main problem that needs to be addressed urgently.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A rationale: Pulmonary embolism would cause chest pain, dyspnea, and hemoptysis, but not petechiae or neurological changes.
Choice B rationale: While chest pain might be associated with myocardial infarction, the combination of symptoms aligns more with a pulmonary embolism.
Choice C rationale: Fat embolism syndrome occurs when fat globules from the bone marrow enter the bloodstream and travel to the lungs, brain, or other organs. This can
cause respiratory distress, neurological impairment, petechiae (reddish-purple spots on the skin), and cardiac dysfunction.
Choice D rationale: Compartment syndrome doesn't typically manifest with respiratory symptoms or reddish-purple spots.
Correct Answer is {"dropdown-group-1":"B","dropdown-group-2":"D"}
Explanation
Choice A rationale: The lab results and clinical picture, such as weight loss, anorexia, and high blood glucose levels, point more toward a hyperglycemic state rather than severe hypoglycemia.
Choice B rationale: The client's elevated blood glucose levels, weight loss, and anorexia suggest a hyperglycemic state, possibly hyperosmolar hyperglycemic state, which requires fluid management and insulin to address the severe dehydration and high blood glucose levels.
Choice C rationale: Although high glucose levels are evident, the absence of significant acidosis (as seen in diabetic ketoacidosis) and extreme ketosis makes this diagnosis less likely.
Choice D rationale: The lab values and clinical presentation do not strongly align with a primary respiratory acidosis diagnosis, which typically involves changes in pH and carbon dioxide levels.
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