A client with Type 2 diabetes is brought into the emergency room in an unresponsive state. A diagnosis of hyperglycemic hyperosmolar nonketotic coma (HHNK) is made. The nurse prepares for the administration of which initial therapy?
Administration of glucagon
Large amounts of IV saline solution
Long-acting IV insulin
Oxygen by nasal cannula
The Correct Answer is B
B. Large amounts of IV saline solution: This is the correct initial therapy. HHNK is characterized by severe dehydration due to osmotic diuresis resulting from hyperglycemia. Therefore, the administration of large amounts of IV saline solution is essential to correct dehydration, restore intravascular volume, and improve tissue perfusion.
A. Glucagon is typically administered to treat severe hypoglycemia, not hyperglycemia.
C. Short-acting or regular insulin is administered initially to lower blood glucose levels rapidly. Long-acting insulin formulations may be used later to maintain glycemic control once the acute phase is managed.
D. Oxygen therapy may be indicated if the client is hypoxic, but it is not the initial therapy for HHNK. The priority in HHNK is to correct dehydration and hyperglycemia through fluid resuscitation and insulin therapy, respectively.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
B. Obtaining blood and urine specimens for culture and sensitivity is a critical first step. These specimens help identify the causative organism(s) and determine their susceptibility to antibiotics, guiding appropriate antibiotic therapy. Prompt initiation of targeted antibiotic treatment is essential in managing sepsis effectively.
A. This action is important for assessing the presence of any urinary tract stones or debris, which can be helpful in diagnosing the cause of the urinary tract infection. However, it is not the first action the nurse should take in managing a client admitted with sepsis secondary to a urinary tract infection.
C. Administering antibiotics before obtaining appropriate cultures may lead to empirical treatment without knowing the specific pathogen causing the infection. It is important to obtain cultures first to guide antibiotic selection and ensure optimal treatment.
D. Contact precautions may be necessary if the client is found to have a multidrug-resistant organism or if there are specific infection control concerns. However, placing the client on contact precautions is not the first action the nurse should take in managing sepsis secondary to a urinary tract infection.
Correct Answer is B
Explanation
B. Aspirin is a nonsteroidal anti-inflammatory drug (NSAID) that can irritate the gastric mucosa and exacerbate gastritis symptoms, including nausea and vomiting. Therefore, aspirin would be contraindicated in a client with acute gastritis, especially if they are experiencing nausea and vomiting.
A. Amoxicillin is an antibiotic commonly used to treat bacterial infections associated with gastritis or peptic ulcers. Therefore, amoxicillin would generally be an appropriate medication for treating gastritis if the underlying cause is bacterial infection.
C. Ranitidine helps alleviate symptoms such as heartburn and indigestion by reducing stomach acid production.
D. Pantoprazole is a proton pump inhibitor (PPI) that is commonly used to treat gastric acid-related disorders, including gastritis and gastroesophageal reflux disease (GERD).
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