A nurse is admitting a client who has diabetic ketoacidosis. Which of the following types of continuous infusions should the nurse initiate?
0.45% saline
NPH insulin
0.9% normal saline
Glargine insulin
The Correct Answer is C
A. 0.45% saline. This is a hypotonic solution, which may be used later in diabetic ketoacidosis (DKA) management, but it is not appropriate for initial fluid resuscitation as it does not rapidly expand intravascular volume.
B. NPH insulin. NPH is an intermediate-acting insulin and is not used for continuous infusion. In DKA, rapid insulin correction is needed, typically with a short-acting insulin like regular insulin.
C. 0.9% normal saline. This isotonic fluid is the first-line choice for fluid replacement in clients with DKA. It helps restore circulating volume and correct dehydration quickly, which is a critical initial intervention.
D. Glargine insulin. Glargine is a long-acting insulin and not suitable for IV infusion. DKA requires the use of short-acting insulin (e.g., regular insulin) administered via IV infusion to correct hyperglycemia and acidosis.
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Related Questions
Correct Answer is B
Explanation
A. Soy. While soy can have mild estrogen-like effects and may influence thyroid function or interact with certain medications, it is not typically associated with hypotension or increased surgical bleeding risk.
B. Black cohosh. Black cohosh is often used to manage menopausal symptoms but is known to cause vasodilation and hypotension in some individuals. Its use can increase the risk of low blood pressure during anesthesia and surgery.
C. Flaxseed. Flaxseed is commonly used for digestive health and cardiovascular support. It may have mild blood pressure–lowering effects but is not strongly linked to significant hypotension during surgery.
D. Probiotics. Probiotics support gut flora and immunity but do not affect blood pressure significantly. They are not associated with intraoperative complications like hypotension.
Correct Answer is A
Explanation
A. Measure the tubing from the nose to the distal port. Proper placement of an NG tube requires measuring from the tip of the nose to the earlobe, then to the xiphoid process. This ensures the tube reaches the stomach without curling or entering the airway.
B. Position the child at a 10 to 20 angle after feeding. A head elevation of at least 30 to 45 degrees is necessary during and after NG feedings to reduce the risk of aspiration. A 10 to 20 degree angle is too low and unsafe for post-feeding positioning.
C. Complete the feeding in 5 min. NG feedings should be given slowly over 20 to 30 minutes to prevent gastrointestinal discomfort, cramping, or vomiting. A 5-minute infusion is too rapid and may overwhelm the child’s digestive capacity.
D. Warm the formula in the microwave. Microwaving formula can lead to uneven heating and hot spots, which pose a burn risk to the child. Formula should be warmed by placing the container in warm water and testing the temperature before administration.
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