A client with diabetic ketoacidosis (DKA) is receiving regular insulin. Which action should the practical nurse (PN) implement to evaluate the effectiveness of the insulin dosage?
Smell the client's breath for resolution of a fruity odor.
Determine the client's orientation to time and space.
Measure the client's urinary output for an increased volume.
Check fingerstick blood glucose for a decrease in the level.
The Correct Answer is D
Regular insulin is the medication of choice for treating DKA. Its main action is to lower blood glucose levels by promoting the uptake of glucose into cells and inhibiting the production of glucose by the liver. Therefore, checking the fingerstick blood glucose level is an important indicator of the effectiveness of the insulin treatment.
A decrease in the blood glucose level indicates that the insulin is working to lower the high blood sugar associated with DKA. This measurement helps the PN assess the response to treatment and adjust the insulin dosage if necessary.
The other actions mentioned are also important assessments in the care of a client with DKA, but they do not specifically evaluate the effectiveness of the insulin dosage:
A. Smelling the client's breath for resolution of a fruity odor is important as it indicates a decrease in ketone production, which is a marker of improving DKA. However, it does not directly evaluate the effectiveness of the insulin dosage.
B. Determining the client's orientation to time and space is part of assessing their neurological status, which is crucial in managing DKA. However, it does not specifically assess the effectiveness of the insulin dosage.
C. Measuring the client's urinary output for an increased volume is important to monitor hydration status and renal function, but it does not directly evaluate the effectiveness of the insulin dosage.
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Related Questions
Correct Answer is C
Explanation
The activity that the PN should suggest to meet the physical and social needs of wheelchair-bound older residents who are mentally alert is an outdoor game of balloon
volleyball. It promotes physical activity, coordination, and social interaction among the residents. It allows them to engage with each other, participate in a fun and inclusive game, and enjoy the outdoor environment. Balloon volleyball can be adapted to accommodate individuals with varying abilities and provide an enjoyable and stimulating experience for wheelchair-bound residents who are mentally alert.
A. A picnic in the park: While a picnic in the park can be enjoyable, it may pose challenges for wheelchair-bound individuals in terms of accessibility and maneuverability. It might limit their participation and engagement in the activity.
B. An outdoor concert: While an outdoor concert can be entertaining, it may not actively engage wheelchair-bound residents. They may be limited in their ability to fully participate and interact with others during the concert.
D. A tea party in the courtyard: While a tea party can be a pleasant social activity, it may not provide the desired physical engagement for wheelchair-bound residents. They may require activities that involve more movement and physical participation.
Correct Answer is B
Explanation
This is the correct answer because it is the best way to assess for signs of ototoxicity, which is a potential adverse effect of aminoglycosides. Ototoxicity is the damage or injury to the inner ear or auditory nerve caused by certain drugs or chemicals. It can result in hearing loss, tinnitus, vertigo, or balance problems. Aminoglycosides are a class of antibiotics that are effective against gram-negative bacteria, but they can also cause ototoxicity by interfering with the function of the hair cells in the cochlea.
The practical nurse (PN) should monitor the client's hearing by asking about any changes in hearing acuity, ringing in the ears, or difficulty understanding speech. The PN should also perform a hearing test using a tuning fork or an audiometer if available. The PN should report any signs of ototoxicity to the healthcare provider and discontinue the aminoglycoside as ordered.
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