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 B

Explanation

A. "You should take this medication on an empty stomach:"
Bumetanide can be taken with or without food. It is not necessary to take it on an empty stomach.
B. "You should monitor for hearing difficulties:"
This is the correct answer. Loop diuretics, including bumetanide, are associated with ototoxicity, which can lead to hearing difficulties or hearing loss. Clients should be instructed to report any changes in hearing.
C. "You should decrease your intake of foods high in potassium:"
Bumetanide can cause potassium loss, but instructing the client to decrease potassium intake may not be appropriate without knowing the client's specific potassium levels. Monitoring potassium levels and adjusting the diet or prescribing supplements as needed would be a more individualized approach.
D. "You should take the medication at bedtime:"
Bumetanide is often prescribed in the morning to avoid disrupting sleep with increased urination during the night. Taking it at bedtime is not a typical recommendation.

Correct Answer is ["20"]

Explanation

Step 1: Convert Weight to Kilograms

1 lb = 0.4536 kg
132 lb × 0.4536 kg/lb = 59.87 kg

Step 2: Calculate Total Dose of Acyclovir

Prescribed dose = 10 mg/kg
Total dose = 59.87 kg × 10 mg/kg = 598.75 mg

Step 3: Determine the Volume of Injectable Solution

Acyclovir IV concentration = 30 mg/mL
Volume = 598.75 mg ÷ 30 mg/mL = 19.96 mL

The nurse should administer 20 mL (rounded to the nearest whole number) of acyclovir IV injectable solution.

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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 providing teaching to a client who has a new prescription for bumetanide for heart failure. Which of the following instructions should the nurse include in the teaching?

Correct Answer is B

Explanation

A nurse is preparing to administer acyclovir 10 mg/kg IV to a client who weighs 132 lbs. Available is acyclovir IV injectable solution 30 ing/ind Hone many mL should the nurse administer? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)

Correct Answer is ["20"]

Explanation

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