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

Answer and Explanation

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.

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Correct Answer is ["D","E"]

Explanation

D. Prophylactic antibiotics are often administered before surgery for appendicitis to reduce the risk of postoperative infection, particularly in cases of suspected or confirmed appendiceal perforation.
E. Keeping the client NPO (nothing by mouth) is a standard precaution before surgery to prevent aspiration of gastric contents during anesthesia induction and to reduce the risk of surgical complications.
A. Applying heat to the abdomen can potentially worsen inflammation and increase the risk of appendiceal rupture.
B. Ambulation may exacerbate the pain and increase the risk of complications, such as appendiceal rupture.
C. Administering a cleansing enema in preparation for surgery may be appropriate in some cases to help prepare the bowel for surgery, particularly if there is concern about bowel obstruction or to reduce the risk of contamination during surgery.

A. assist clients who are unable to eat but have active GI function. B. give short term nutrition after a surgical procedure. C. provide all of the client's nutritional needs in a hypertonic solution. D. prevent complications after a laparotomy for a bowel obstruction.

Correct Answer is C

Explanation

C. TPN does provide all of the client's nutritional needs, including carbohydrates, proteins, fats, vitamins, minerals, and electrolytes, in a hypertonic solution. The hypertonicity of the solution is necessary to prevent fluid overload and ensure compatibility with the vasculature. The hypertonic solution allows for higher nutrient concentrations to be delivered without exceeding vascular capacity.
A. TPN is indicated for clients who are unable to tolerate enteral nutrition (feeding through the gastrointestinal tract) or have impaired absorption, digestion, or utilization of nutrients despite having active GI function.
B. TPN may be used temporarily after a surgical procedure if the client is unable to tolerate oral or enteral feeding or if enteral nutrition is contraindicated due to the surgical site or condition. However, TPN is not limited to short-term use after surgery and may be required for an extended period in clients with chronic conditions or prolonged inability to tolerate enteral nutrition.
D. TPN may be used in some cases after a laparotomy for a bowel obstruction, particularly if enteral nutrition is contraindicated or if the client is unable to tolerate oral intake. However, TPN is not primarily used to prevent complications after surgery but rather to provide nutritional support when enteral feeding is not feasible or sufficient.

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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?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is caring for a client who has suspected appendicitis. While waiting for surgery, nursing interventions for this client would include: (NOTE: Assume that there are physician's orders for all interventions which would require them.) (SELECT ALL THAT APPLY)

Correct Answer is ["D","E"]

Explanation

The nurse is caring for a client receiving total parenteral nutrition (TPN). The nurse understands that the best explanation for utilizing TPN is to:

Correct Answer is C

Explanation

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