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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Free Nursing Study Resources

Correct Answer is ["B","C","D"]

Explanation

A. "Take the medication with an antacid if it upsets your stomach."
Explanation: Antacids may interfere with the absorption of iron. It is generally recommended to take iron supplements on an empty stomach or with vitamin C-containing foods to enhance absorption.
B. "Stop taking the medication if your stools become green or black."
Explanation: Ferrous sulfate can cause stools to become dark green or black, which is a normal and expected side effect. However, excessive black, tarry stools may indicate gastrointestinal bleeding and should be reported to the healthcare provider.
C. "Drink the elixir using a straw to prevent staining your teeth."
Explanation: Ferrous sulfate elixir can stain the teeth. Using a straw helps bypass direct contact with the teeth, reducing the risk of staining.
D. "Increase your fiber intake to prevent constipation."
Explanation: Iron supplements, including ferrous sulfate, can cause constipation. Increasing fiber intake can help alleviate constipation.
E. "Increase your intake of dairy products to increase the absorption of this medication."
Explanation: Calcium-containing foods, such as dairy products, can inhibit the absorption of iron. It is advisable to take iron supplements separately from calcium-containing foods.

A. This medication should be taken on an empty stomach. B. Increase the amount of potassium in your diet. C. "Take the medication before going to bed D. "Weigh yourself on the same day each week

Correct Answer is B

Explanation

A. This medication should be taken on an empty stomach:
Furosemide can be taken with or without food. Taking it with food can help reduce stomach upset, so there is no requirement to take it on an empty stomach.
B. Increase the amount of potassium in your diet:
This is the correct answer. Furosemide is a loop diuretic that can lead to potassium loss through increased urine output. Supplementing potassium through diet or potassium supplements may be necessary to prevent hypokalemia.
C. Take the medication before going to bed:
Furosemide is often recommended to be taken earlier in the day to avoid disrupting sleep with increased urination during the night. Taking it before going to bed is not a typical recommendation.
D. Weigh yourself on the same day each week:
Regular monitoring of weight is important in clients taking diuretics, but it is typically recommended to weigh daily at the same time each day, not weekly.

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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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