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?

Potassium chloride 10 mEq/hr

Bicarbonate by IV infusion

Subcutaneous insulin injections

0.9% sodium chloride 15 mL/kg/hr

Answer and Explanation

The Correct Answer is D

Choice A rationale: While potassium replacement is important in diabetic ketoacidosis, fluid resuscitation to restore intravascular volume, improve renal perfusion, and flush out ketones.
Choice B rationale: Bicarbonate infusion might be considered in severe acidosis, but fluid administration is the priority.
Choice C rationale: The priority intervention for a client with diabetic ketoacidosis and very high blood glucose levels is to initiate fluid resuscitation to restore intravascular volume, improve renal perfusion, and flush out ketones.
Choice D rationale: The first intervention the nurse should initiate is fluid resuscitation with 0.9% sodium chloride at a rate of 15 mL/kg/hr to restore intravascular volume, improve renal perfusion, and flush out ketones.

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Correct Answer is B

Explanation

A. Tinnitus, or ringing in the ears, is not a common adverse effect of ergotamine, though it may occur with some other medications used for migraines. Ergotamine primarily affects the blood vessels and nervous system.

B. Paresthesias, which involve tingling, numbness, or a burning sensation, can occur as an adverse effect of ergotamine due to its vasoconstrictive properties. Clients should be informed to report any unusual sensations in their extremities.

C. Blurred vision is not typically associated with ergotamine use. It could be a sign of another underlying condition or side effect from other medications but is not directly related to ergotamine.

D. Hematuria, or blood in the urine, is not a known adverse effect of ergotamine. The medication's effects are mainly related to the vascular system, not the kidneys or urinary tract.

A. "Insert the entire length of the needle into the skin during injection." B. "Massage the insertion site after injecting the medication." C. "Alternate injection sites between the sides of the abdomen." D. "Grasp the skin between the thumb and forefinger while injecting the medication." E. "Expel the air bubble from the prefilled syringe."

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

Explanation

Choice A rationale: For subcutaneous injections like enoxaparin, the entire length of the needle needs to be inserted to ensure that the medication reaches the fatty tissue under the skin and reduces the risk of bleeding or bruising.
Choice B rationale: The client should not massage the insertion site after injecting the medication, as this may increase the risk of hematoma formation.
Choice C rationale: The client should alternate injection sites between the sides of the abdomen to prevent bruising and irritation.
Choice D rationale: The client should also grasp the skin between the thumb and forefinger while injecting the medication to create a fold of tissue. This ensures that the medication is delivered into the subcutaneous layer and not the muscle.
Choice E rationale: The client should not expel the air bubble from the prefilled syringe, as this helps to seal the medication in the tissue and prevent leakage while ensuring that you receive the full dose of medication.

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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?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is providing teaching about the adverse effects of ergotamine to a client who has migraine headaches. Which of the following adverse effects should the nurse include in the teaching?

Correct Answer is B

Explanation

A nurse is teaching a client about self-administration of enoxaparin. Which of the following instructions should the nurse include? (Select all that apply.)

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

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