A nurse is caring for a client who has diabetic ketoacidosis and hypoxia.
Which of the following actions should the nurse take first?
Obtain a prescription for supplemental oxygen.
Obtain a prescription to administer intravenous fluids.
Obtain a prescription to administer insulin.
Obtain a prescription to check the client's glucose level.
The Correct Answer is A
Choice A rationale
Obtaining a prescription for supplemental oxygen is the first action as hypoxia must be corrected immediately to ensure adequate tissue oxygenation.
Choice B rationale
Obtaining a prescription to administer intravenous fluids is essential to address dehydration but is secondary to correcting hypoxia.
Choice C rationale
Obtaining a prescription to administer insulin is crucial to manage hyperglycemia in diabetic ketoacidosis but not the initial step in this context.
Choice D rationale
Obtaining a prescription to check the client's glucose level is necessary for monitoring but does not address the immediate need for oxygenation.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A rationale
Cyanosis is a late sign of hypoxemia and not the most common initial manifestation of ARDS. It indicates severe oxygen deprivation but doesn’t typically appear first.
Choice B rationale
Diaphoresis, or excessive sweating, can occur with many conditions causing distress, but it’s not specifically the most common presenting symptom of ARDS. It's more of a nonspecific symptom of stress.
Choice C rationale
Somnolence, or drowsiness, might occur in severe respiratory distress when oxygen levels drop significantly, but it’s not the primary or most common presenting manifestation of ARDS.
Choice D rationale
Dyspnea, or difficulty breathing, is the hallmark of ARDS and the most common presenting symptom. It occurs due to the acute onset of severe hypoxemia caused by the underlying pathophysiology of ARDS.
Correct Answer is A
Explanation
Choice A rationale
Agitation is a common manifestation of hypoxemia due to insufficient oxygen reaching the brain and other vital organs.
Choice B rationale
Dysphagia, or difficulty swallowing, is not a typical manifestation of hypoxemia during an asthma attack.
Choice C rationale
Nausea can occur but is not a primary indicator of hypoxemia.
Choice D rationale
Hypotension may occur with severe hypoxemia but is not a direct manifestation of asthma-related hypoxemia.
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