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 ["3"]
Explanation
Adolescent weight = 88 lb, 1 kg = 2.2 lb (to convert lb to kg), 88 lb / 2.2 = 40 kg (approx.), 150 mg/kg dose x 40 kg = 6000 mg, Available dose = 500 mg/tab, 6000 mg / 500 mg/tab
= 12 tabs per day, divided equally every 6 hrs
= 12 tabs / 4 doses
= 3 tabs per dose.
Correct Answer is A
Explanation
Choice A rationale: Citalopram is a selective serotonin reuptake inhibitor (SSRI) that increases the level of serotonin in the brain. Serotonin syndrome is a rare but serious adverse effect of SSRIs that can cause confusion, agitation, tremors, seizures, and coma. The nurse should report this finding to the provider immediately, as it can be life-threatening.
Choice B rationale: Insomnia can occur as an adverse effect of citalopram but might not be as immediately concerning as confusion.
Choice C rationale: Bruxism (teeth grinding) can be a side effect of citalopram but might not pose an immediate risk compared to confusion.
Choice D rationale: Weight loss, while a potential side effect, might not be as urgent or immediately concerning as confusion.
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