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 A

Explanation

A. Decrease in urine output:
This is the correct answer. Desmopressin is a synthetic form of antidiuretic hormone (ADH) that works to reduce urine output in individuals with diabetes insipidus. A decrease in urine output indicates a positive response to the medication.
B. Increase in serum glucose:
Desmopressin does not have a direct effect on serum glucose levels. Its primary action is to increase water reabsorption in the kidneys, reducing urine output.
C. Increase in WBC count:
Desmopressin does not have a direct impact on white blood cell (WBC) count. Its main action is on fluid balance and urine concentration.
D. Decrease in blood pressure:
Desmopressin can cause a mild increase in blood pressure, particularly at higher doses. However, blood pressure changes are not the primary therapeutic effect of desmopressin in the context of diabetes insipidus.

A. Cover the medication on the client's skin with a sterile gauze pad. B. Spread the medication over a 12.7 cm (5 in) area of the client's skin, C. Measure the dosage of medication using the applicator paper D. Apply the medication to the same site for three consecutive days

Correct Answer is B

Explanation

A. Cover the medication on the client's skin with a sterile gauze pad:
Nitroglycerin ointment is typically applied directly to the skin, and covering it with a sterile gauze pad is not a common practice. The ointment is absorbed through the skin.
B. Spread the medication over a 12.7 cm (5 in) area of the client's skin:
This is the correct answer. Nitroglycerin ointment is usually applied to a specific area of the skin, and the recommended area is often around 12.7 cm (5 inches). The nurse should spread the ointment evenly over this specified area.
C. Measure the dosage of medication using the applicator paper:
Nitroglycerin ointment is typically measured using a dosing strip or measuring paper provided with the medication. Using the applicator paper to measure the appropriate dosage is a common practice.
D. Apply the medication to the same site for three consecutive days:
Nitroglycerin ointment is often rotated to different sites to prevent local irritation or tolerance. It is not typically applied to the same site for three consecutive days.

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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?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who has diabetes insipidus and is receiving desmopressin by intermittent IV balus. Which of the fediowing manifestations should indicate to the nurse a therapeutic response to the medication?

Correct Answer is A

Explanation

A nurse is preparing to administer nitroglycerin topical ointment to a client. Which of the following actions should the nurse plan to take?

Correct Answer is B

Explanation

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