A nurse in the emergency department is admitting a client who has diabetic ketoacidosis and a blood glucose level of 100 mg/dl. Which of the following interventions should the nurse initiate first?

Potassium chloride 10 mEq/hr

Bicarbonate by IV infusion

Subcutaneous insulin injections

0.99% sodium chloride 15 mL/kg/hr

Answer and Explanation

The Correct Answer is D

A. Potassium chloride 10 mEq/hr:
While potassium replacement is crucial in DKA, initiating it before fluid resuscitation can lead to further complications. Insulin administration can drive potassium back into cells, potentially causing hypokalemia. Fluid resuscitation helps address dehydration and electrolyte imbalances.
B. Bicarbonate by IV infusion:

Bicarbonate therapy is generally reserved for severe cases of acidosis, and its use in DKA is controversial. In this scenario, the blood glucose level is not significantly elevated, and the focus should be on fluid resuscitation and insulin administration.
C. Subcutaneous insulin injections:
While insulin is a critical component of DKA management, it should be administered intravenously for faster and more precise control of blood glucose levels. Subcutaneous insulin injections are not the initial route of administration in DKA.
D. 0.9% sodium chloride 15 mL/kg/hr:
This is the correct answer. The first step in DKA management is fluid resuscitation with isotonic saline (0.9% sodium chloride). The goal is to address dehydration, restore intravascular volume, and improve perfusion. Insulin therapy and other interventions follow fluid resuscitation.

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Correct Answer is D

Explanation

A. Increased blood pressure: Heparin does not typically directly affect blood pressure. However, if there are other underlying conditions or complications related to the reason for heparin use, it might indirectly influence blood pressure. But a high aPTT level itself wouldn't directly cause an increase in blood pressure.
B. Decreased temperature: Heparin does not usually affect body temperature. Changes in temperature might occur due to other factors, but they are not directly related to heparin administration or its effects on aPTT.
C. Decreased respiratory rate: Heparin does not typically affect the respiratory rate directly. Changes in respiratory rate might occur due to other causes but are not directly correlated with heparin administration or its effects on aPTT.
D. Increased pulse rate: Heparin, especially when aPTT is elevated, might indicate that the blood is less likely to clot. An increased pulse rate could be indicative of compensatory mechanisms due to potential bleeding or changes in clotting factors influenced by heparin. It's essential to monitor for an increased pulse rate as a potential sign of bleeding complications associated with anticoagulant therapy.

A. Weight loss B. increase in pulse rate C. Increased sleeping D. Warmer skin

Correct Answer is C

Explanation

A. Weight loss:
Weight lossis not typically associated with methimazole use. In fact, hyperthyroidism (such as in Graves’ disease) can lead to unintentional weight loss due to increased metabolism. Methimazole helps normalize thyroid function, but it doesn’t directly cause weight loss.
B. Increase in pulse rate:
While an increased pulse rate is a symptom of hyperthyroidism, the goal of methimazole treatment is to normalize thyroid function and, consequently, decrease the pulse rate over time.
C. Increased sleeping:
Increased sleeping:Methimazole works by inhibiting the production of thyroid hormones (T3 and T4) in the thyroid gland. It helps normalize thyroid function by reducing excessive hormone synthesis.As thyroid hormone levels decrease due to methimazole, the client’s metabolic rate may slow down. This can lead to feelings of fatigue and increased need for rest, resulting in more sleep.
D. Warmer skin:
Warmer skin is a symptom of hyperthyroidism. With effective treatment using methimazole, the normalization of thyroid function should lead to improved thermoregulation, potentially reducing the sensation of warmer skin.

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A nurse in the emergency department is admitting a client who has diabetic ketoacidosis and a blood glucose level of 100 mg/dl. Which of the following interventions should the nurse initiate first?

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Naxlex Comprehensive Predictor Exams

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Correct Answer is D

Explanation

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Correct Answer is C

Explanation

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