A client is admitted with diabetic ketoacidosis (DKA) and is receiving an IV infusion of 0.9% sodium chloride and insulin. Two hours later, the client's serum laboratory results show a decrease in the serum blood glucose from 580 to 430 mg/dL (32.2 to 23.86 mmol/L). It is most
important for the nurse to monitor which additional laboratory result?
Reference Range

Serum potassium.

Urine ketones.

Serum sodium.

Blood urea nitrogen (BUN).

Answer and Explanation

The Correct Answer is A

A.   Serum potassium. Insulin therapy causes potassium to move into cells, which can lead to hypokalemia. Monitoring serum potassium is critical because significant drops can lead to cardiac arrhythmias and other complications.
B.   Urine ketones. While monitoring ketones is important for assessing the resolution of DKA, it is not as immediately critical as monitoring potassium levels.
C.   Serum sodium. Sodium levels are important but typically do not change as rapidly as potassium levels during DKA treatment.
D.   Blood urea nitrogen (BUN). BUN levels provide information about kidney function and hydration status but are less immediately critical than potassium levels in the context of insulin therapy for DKA.

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Correct Answer is B

Explanation

A. While monitoring erythrocytes, hemoglobin, and hematocrit is important in clients with ESRD due to the risk of anemia associated with kidney dysfunction, it is not the primary focus of monitoring for ESRD.

B. Clients with ESRD often experience electrolyte imbalances, including hyperkalemia (high potassium), hypocalcemia (low calcium), and hyperphosphatemia (high phosphorus). Monitoring these electrolyte levels is crucial to prevent complications such as cardiac arrhythmias, bone
disease, and soft tissue calcifications.

C. While blood pressure, heart rate, and temperature are essential vital signs to monitor in all clients, they are not specific laboratory tests for monitoring ESRD. However, blood pressure monitoring is particularly important in ESRD due to the increased risk of hypertension and its associated complications.

D. Monitoring leukocytes, neutrophils, and thyroxine levels is not typically a primary concern in clients with ESRD. Leukocyte and neutrophil levels may be monitored to assess for signs of infection, but they are not specific to ESRD. Thyroxine levels are typically monitored in clients with thyroid disorders, not ESRD.

A. Keep diabetic medication on schedule as prescribed. B. Limit maximum daily fat intake to 15% of total calories. C. Check blood sugar levels every four to six hours every day. D. Restrict alcoholic beverages to no more than 1-2 per week.

Correct Answer is A

Explanation

A. Keep diabetic medication on schedule as prescribed.

This is the correct answer because maintaining a regular schedule for diabetic medication is crucial for managing blood glucose levels and preventing complications.

B. Limit maximum daily fat intake to 15% of total calories.

While reducing fat intake can be beneficial for overall health, it is not directly related to managing acute blood glucose levels or preventing immediate complications of diabetes.

C. Check blood sugar levels every four to six hours every day.

Frequent monitoring of blood sugar levels is important, but checking every four to six hours may not be necessary for all clients, especially if they are not on insulin or if their diabetes is well-controlled. It depends on individual needs and physician recommendations.

D. Restrict alcoholic beverages to no more than 1-2 per week.

Limiting alcohol intake is good advice for overall health and diabetes management, but it is not the most critical action compared to keeping medications on schedule to prevent complications.

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Naxlex Comprehensive Predictor Exams

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