A client with type 1 diabetes is admitted to the emergency department for DKA. Which assessment findings should the nurse expect to note?

Fruity breath odor and increased respiratory rate.

Hunger and hypertension

Cold, clammy skin and irritability

Sweating and tremors

Answer and Explanation

The Correct Answer is A

A.   DKA is characterized by the production of ketones, which can lead to a fruity or acetone-like odor on the breath. Additionally, the increased respiratory rate (Kussmaul breathing) occurs as the body attempts to compensate for metabolic acidosis by blowing off carbon dioxide.
B.   While clients with diabetes may experience hunger, it is not a primary symptom of DKA. Hypotension (rather than hypertension) is more commonly observed due to dehydration and fluid loss associated with DKA.

C.   Cold, clammy skin suggests the body is in a sympathetic state due to low blood sugar. While irritability can occur in various situations, it is not a hallmark sign of DKA.
D.   Sweating and tremors are symptoms of low blood sugar levels and are not characteristic of DKA. In DKA, patients typically present with dry skin due to dehydration.

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Correct Answer is A

Explanation

A. Kidney disease is one of the most common causes of secondary hypertension. Conditions such as chronic kidney disease or renal artery stenosis can lead to increased blood pressure due to fluid retention or increased renin production.
B. While pain can cause temporary increases in blood pressure due to the body's stress response, it is not an identifiable cause of secondary hypertension. Pain-related hypertension is usually acute and resolves once the pain is managed, rather than being a chronic condition.
C. Glaucoma is an eye condition characterized by increased intraocular pressure, but it is not a cause of hypertension. Although systemic hypertension can affect eye health, glaucoma itself does not cause secondary hypertension. Therefore, this is not an identifiable cause.
D. Anemia does not directly cause secondary hypertension. While severe anemia can sometimes result in compensatory mechanisms that might elevate blood pressure, it is not a recognized or direct cause of secondary hypertension. Thus, it is not a primary concern in this context.

A. Avoid cleansing the area before application of the cream. B. Apply a thin layer of cream and rub it into the area thoroughly. C. Apply the cream over the entire body. D. Apply a thick layer of cream to affected areas only.

Correct Answer is B

Explanation

A. The area should be cleansed gently before applying the cream to remove any irritants and allow for better absorption of the medication. Proper cleansing can help enhance the effectiveness of the corticosteroid.
B. Topical corticosteroids should be applied in a thin layer to the affected area and gently rubbed in. Applying too much can increase the risk of side effects, and a thin application ensures better absorption without overwhelming the skin.
C. The corticosteroid should be applied only to the affected areas of the skin, not the entire body. Overuse can lead to systemic absorption and potential side effects, particularly in children, whose skin is more permeable.
D. While it is important to cover the affected areas, applying a thick layer is not recommended. A thin layer is usually sufficient and minimizes the risk of side effects from excessive corticosteroid use.

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A client with type 1 diabetes is admitted to the emergency department for DKA. Which assessment findings should the nurse expect to note?

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Naxlex Comprehensive Predictor Exams

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Correct Answer is B

Explanation

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