A nurse is caring for a client who has diabetic ketoacidosis. Which of the following manifestations should the nurse expect?

Blood glucose level below 40 mg/dL

Malignant hypertension

Cheyne-Stokes breathing

Acetone odor to breath

Answer and Explanation

The Correct Answer is D

A. Blood glucose level below 40 mg/dL: Diabetic ketoacidosis (DKA) is characterized by hyperglycemia, typically with blood glucose levels significantly elevated above normal, often exceeding 250 mg/dL. A glucose level below 40 mg/dL would indicate hypoglycemia, which is not a feature of DKA.

B. Malignant hypertension: Malignant hypertension is a condition characterized by extremely high blood pressure and is not directly associated with DKA. DKA primarily involves issues with glucose and acid-base balance rather than hypertension.

C. Cheyne-Stokes breathing: Cheyne-Stokes breathing is a specific pattern of periodic breathing typically seen in severe neurologic conditions or heart failure, not in DKA. DKA is associated with Kussmaul breathing, which is deep and rapid breathing as the body attempts to compensate for metabolic acidosis.

D. Acetone odor to breath: An acetone (fruity) odor to the breath is a classic sign of DKA due to the presence of ketones in the blood and urine. This occurs because the body is breaking down fatty acids for energy, leading to the production of ketones, which are then excreted through the breath and urine.

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Correct Answer is D

Explanation

A. Anti-inflammatory: While aspirin does have anti-inflammatory properties, it is not given for this purpose in the context of preventing heart attacks. The anti-inflammatory action is more relevant in conditions like arthritis.

B. Analgesic: Aspirin is an analgesic and can relieve pain, but this is not the primary reason for its use in clients with a history of myocardial infarction.

C. Antipyretic: Aspirin has antipyretic properties, meaning it can reduce fever, but this is not the reason it is prescribed following a myocardial infarction.

D. Antiplatelet aggregate: Aspirin is used in clients with a history of myocardial infarction for its antiplatelet properties. It helps to prevent the aggregation of platelets, thereby reducing the risk of blood clots that can lead to another heart attack.

A. Ketones present in urine B. Elevated C-peptide blood level C. Serum blood glucose 300 mg/dL D. HbA1c 12.6% E. Hypertension F. ABG results

Correct Answer is ["A","C","D","F"]

Explanation

☑️ Ketones present in urine: The presence of ketones in urine indicates that the body is breaking down fats for energy due to insufficient insulin, a hallmark of DKA. This ketogenesis occurs when the body cannot utilize glucose properly, leading to the production of ketone bodies which are excreted in the urine.

☐ Elevated C-peptide blood level: Elevated C-peptide levels typically indicate that the pancreas is still producing insulin. In the context of DKA, particularly in Type 1 diabetes, C-peptide levels are usually low or undetectable due to the lack of insulin production. Therefore, elevated C-peptide is not a risk factor for DKA.

☑️ Serum blood glucose 300 mg/dL: Elevated blood glucose levels (≥250 mg/dL) are a significant risk factor for DKA. Hyperglycemia indicates poor glycemic control, which, if prolonged and severe, can lead to ketone production and subsequent ketoacidosis.

☑️ HbA1c 12.6%: An HbA1c level of 12.6% indicates chronic poor blood glucose control. A normal HbA1c is below 5.7%, and levels above 6.5% suggest diabetes. This very high level suggests persistent hyperglycemia, increasing the risk for acute complications like DKA.

☐ Hypertension: Hypertension is not directly related to DKA. While it is a common comorbidity in diabetes, it does not contribute to the metabolic conditions leading to ketoacidosis. DKA is more closely related to hyperglycemia, insulin deficiency, and increased ketone production rather than blood pressure levels.

☑️ ABG results: The ABG results indicate metabolic acidosis, a hallmark of DKA. The low pH (7.20) and low bicarbonate (HCO3- at 12 mEq/L) confirm acidosis, and in the context of hyperglycemia and ketonuria, it strongly suggests DKA. The normal PaCO2 suggests that there is no significant respiratory compensation for the metabolic acidosis.

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A nurse is caring for a client who has diabetic ketoacidosis. Which of the following manifestations should the nurse expect?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client who has a history of myocardial infarction (MI) is prescribed aspirin 325 mg. The nurse recognizes that the aspirin is given due to which of the following actions of the medication?

Correct Answer is D

Explanation

A nurse is caring for a client in the emergency department. Exhibits Which of the following assessment findings would indicate to the nurse that the client is at risk for developing diabetic ketoacidosis (DKA)? (Select All that Apply.)

Correct Answer is ["A","C","D","F"]

Explanation

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