A nurse in the emergency department is admitting a client who has diabetic ketoacidosis and a blood glucose level of 800 mg/dL.
Which of the following interventions should the nurse initiate first?
Subcutaneous insulin injections.
Bicarbonate by IV infusion.
0.9% sodium chloride 15 m/kg/hr.
Potassium chloride 10 mEq/hr.
The Correct Answer is C
The first intervention for a client with diabetic ketoacidosis and a blood glucose level of 800 mg/dL should be to initiate fluid replacement therapy with 0.9% sodium chloride at a rate of 15 mL/kg/hr.
This will help to replace fluids lost through excessive urination and to dilute the excess sugar in the blood.
Choice A is wrong because subcutaneous insulin injections are not the first intervention for diabetic ketoacidosis.
Insulin therapy is generally given intravenously.
Choice B is wrong because bicarbonate by IV infusion is not the first intervention for diabetic ketoacidosis.
Choice D is wrong because potassium chloride at a rate of 10 mEq/hr is not the first intervention for diabetic ketoacidosis.
Electrolyte replacement may be necessary to replace minerals such as sodium, potassium, and chloride, but this is not the first intervention 2.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale: Administering filgrastim after chemotherapy is a standard practice to boost white blood cell count. However, filgrastim should not be given within 24 hours before or after chemotherapy, as it can affect the efficacy and increase the risk of side effects. Administering the medication 12 hours after chemotherapy falls within this contraindicated window, necessitating an incident report.
Choice B rationale: Filgrastim can be stored at room temperature for short periods, and 2 hours is generally within acceptable limits for stability.
Choice C rationale: An absolute neutrophil count of 2,500/mm³ is within the normal range, and there is no contraindication for administering filgrastim.
Choice D rationale: Flushing the client's IV line with dextrose 5% in water before and after administering filgrastim is not appropriate, as this medication is typically administered with saline solution. Using an incorrect flushing solution could affect the medication's efficacy or compatibility, necessitating an incident report.
Correct Answer is D
Explanation
Improved cognition should indicate to the nurse that the treatment with a hypertonic solution for hyponatremia is effective.
Hyponatremia can cause confusion and other neurological symptoms, so an improvement in cognition would suggest that the treatment is working to correct the electrolyte imbalance.
Choice A is wrong because Chvostek’s sign is a clinical sign of hypocalcemia, not hyponatremia.
Choice B is wrong because while vomiting can be a symptom of hyponatremia, a decrease in vomiting alone does not necessarily indicate that the treatment is effective.
Choice C is wrong because while hyponatremia can cause cardiac arrhythmias, the absence of arrhythmias alone does not necessarily indicate that the treatment is effective.
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