A nurse is caring for a client who has diabetic ketoacidosis and is receiving intravenous fluids. Which of the following electrolytes should the nurse monitor closely for signs of imbalance? (Select all that apply.)

Chloride.

Phosphate.

Bicarbonate.

Sulfate.

Potassium.

Answer and Explanation

Correct Answer : C,E

Choice A reason:

Chloride is not a major electrolyte that is affected by diabetic ketoacidosis (DKA) Chloride levels may be low, normal or high depending on the acid-base status and hydration of the client. Therefore, chloride is not a priority electrolyte to monitor for signs of imbalance.

Choice B reason:

Phosphate is also not a major electrolyte that is affected by DKA. Phosphate levels may be low due to insulin therapy or high due to renal impairment, but these are not directly related to DKA. Therefore, phosphate is not a priority electrolyte to monitor for signs of imbalance.

Choice C reason:

Bicarbonate is a major electrolyte that is affected by DKA. Bicarbonate levels are low in DKA due to metabolic acidosis caused by the accumulation of ketones in the blood. Low bicarbonate levels can lead to symptoms such as nausea, vomiting, abdominal pain, confusion and coma. Therefore, bicarbonate is a priority electrolyte to monitor for signs of imbalance.

Choice D reason:

Sulfate is not a major electrolyte that is affected by DKA. Sulfate levels are not routinely measured in clinical practice and have no significant role in DKA. Therefore, sulfate is not a priority electrolyte to monitor for signs of imbalance.

Choice E reason:

Potassium is a major electrolyte that is affected by DKA. Potassium levels can be high or low in DKA depending on several factors such as insulin therapy, fluid replacement, renal function and acid-base status. High or low potassium levels can cause cardiac arrhythmias, muscle weakness, paralysis and respiratory failure. Therefore, potassium is a priority electrolyte to monitor for signs of imbalance.

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Correct Answer is A

Explanation

Decreased hCG levels are abnormal regarding hCG levels in pregnancy.hCG is a hormone that plays an important role in pregnancy, and levels can vary widely at this time and between individuals.However, during early pregnancy, hCG levels typically double every two to three days.Low or declining hCG levels can signal a problem with the pregnancy, such as an impending miscarriage or ectopic pregnancy.

Choice B is wrong because unchanged hCG levels are also abnormal regarding hCG levels in pregnancy.

As mentioned above, hCG levels should increase rapidly during the first few weeks of pregnancy.

Choice C is wrong because increased hCG levels are normal regarding hCG levels in pregnancy.Levels of hCG can vary widely from one pregnant woman to another, but they generally peak at around 8 to 14 weeks after conception.

Choice D is wrong because increased prolactin levels are not related to hCG levels in pregnancy.

Prolactin is another hormone that stimulates milk production in the breasts.

Prolactin levels rise during pregnancy and breastfeeding, but they do not affect hCG levels.

A. I will need to increase my protein intake by 25 g per day while I am pregnant B. I will need to increase my calcium intake by 600 mg per day while I am breastfeeding C. I will need to increase my calorie intake by 500 kcal per day during my third trimester D. I will need to increase my iron intake by 10 mg per day while I am pregnant

Correct Answer is A

Explanation

I will need to increase my protein intake by 25 g per day while I am pregnant.” Protein is essential for the growth and development of the fetus and the placenta, as well as for the increased blood volume and maternal tissues.

The recommended dietary allowance (RDA) for protein during pregnancy is 71 g per day, which is 25 g more than the RDA for non-pregnant women.

Choice B is wrong because the calcium intake does not need to increase during lactation.

The RDA for calcium for lactating women is the same as for non-lactating women, which is 1000 mg per day for women aged 19 to 50 years.

Calcium absorption and retention are enhanced during lactation, and bone loss that may occur is usually reversible after weaning.

Choice C is wrong because the calorie intake does not need to increase by 500 kcal per day during the third trimester.

The estimated energy requirement (EER) for pregnant women increases by 340 kcal per day in the second trimester and by 452 kcal per day in the third trimester.

However, these values may vary depending on the pre-pregnancy weight, activity level, and rate of weight gain of the individual woman.

Choice D is wrong because the iron intake needs to increase by more than 10 mg per day while pregnant.

The RDA for iron during pregnancy is 27 mg per day, which is 9 mg more than the RDA for non-pregnant women.

However, this amount may not be enough to prevent iron deficiency anemia in some pregnant women, especially those who start pregnancy with low iron stores or have high iron losses due to bleeding or multiple pregnancies.

Therefore, iron supplements are often recommended for pregnant women, especially in the second and third trimesters.

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