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 C
Explanation
Choice A rationale: Naloxone reverses opioid effects and may lead to decreased pain relief.
Choice B rationale: Naloxone might cause an increase in blood pressure rather than a decrease.
Choice C rationale: Naloxone is an opioid antagonist used to reverse the effects of opioids like morphine. Increased respiratory rate is a therapeutic effect of naloxone, countering the respiratory depression caused by opioids.
Choice D rationale: Naloxone's primary action is to counter opioid-induced respiratory depression, not directly address nausea.
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.
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