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 C
Explanation
A. Place the client in a side-lying position for the procedure. Paracentesis is typically performed with the client in a high-Fowler’s or upright position, allowing fluid to collect in the lower abdomen for easier drainage.
B. Administer a low-volume hypertonic enema the night before the procedure. An enema is not required for a paracentesis, as the procedure involves the peritoneal cavity, not the bowel.
C. Weigh the client before and after the procedure. Weighing the client helps assess the amount of fluid removed and monitor for fluid shifts. It is a key part of pre- and post-procedural care to evaluate the effectiveness of the intervention.
D. Ensure the client has a full bladder just prior to the procedure. A full bladder increases the risk of injury during needle insertion. The bladder should be emptied before the procedure to prevent accidental puncture.
Correct Answer is []
Explanation
This client has multiple risk factors for pancreatitis, including type 2 diabetes mellitus, hyperlipidemia, and a history of cardiovascular disease. Although the vital signs are relatively stable, the presence of risk factors and a likely clinical presentation (e.g., abdominal symptoms assumed by context) are consistent with pancreatitis. In acute pancreatitis, the pancreas becomes inflamed and digestive enzymes may attack pancreatic tissue.
NPO status is essential to rest the gastrointestinal tract and reduce pancreatic stimulation. Opioids are typically required due to the severity of abdominal pain. Elevated glucose can result from impaired insulin production due to pancreatic inflammation. Jaundice may occur if the bile duct is obstructed due to pancreatic swelling or inflammation.
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