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
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale: Hydrochlorothiazide does not typically cause hypocalcemia.
Choice B rationale: Hydrochlorothiazide is a diuretic that can cause potassium loss.
Hypokalemia (low potassium levels) is an adverse effect that needs monitoring due to its potential to exacerbate heart failure and lead to various complications.
Choice C rationale: Hydrochlorothiazide is more associated with hyponatremia rather than hypernatremia.
Choice D rationale: Hydrochlorothiazide is not linked to causing hypermagnesemia.
Correct Answer is B
Explanation
A. Determine factors that led to the omission: While determining the factors that led to the omission is important for preventing future errors, it is not the immediate priority when a medication has been missed. Assessing the client for adverse reactions takes precedence to ensure their safety and well-being.
B. Assess the client for adverse reactions: Assessing the client for adverse reactions is the immediate priority when a medication has been missed. This allows the nurse to promptly identify any potential harm or complications resulting from the missed dose and take appropriate actions to mitigate them.
C. Report the missed dosage to the client's provider: Reporting the missed dosage to the client's provider is important for documentation and continuity of care, but it should follow the assessment of the client for adverse reactions. Immediate assessment of the client's condition takes precedence to address any immediate concerns.
D. File an incident report: Filing an incident report is necessary for documenting the missed dosage and analyzing the factors that contributed to the error. However, it should be done after assessing the client for adverse reactions and reporting the incident to the provider. The incident report helps in identifying system issues and implementing measures to prevent similar errors in the future.
Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.
Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today
Report Wrong Answer on the Current Question
Do you disagree with the answer? If yes, what is your expected answer? Explain.
Kindly be descriptive with the issue you are facing.