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 B

Explanation

A. Maintain oxygen saturations greater than or equal to 92%: Maintaining oxygen saturation is important but is not the immediate priority. The symptoms suggest a possible myocardial infarction (heart attack), and the primary focus should be on immediate diagnostic assessment and treatment.

B. Obtain an EKG: The symptoms described (pain in the jaw, back, and shoulder, along with shortness of breath and nausea) are classic signs of a myocardial infarction. An EKG is essential to quickly diagnose this potentially life-threatening condition and guide further treatment.

C. Administer enteric-coated acetaminophen: Acetaminophen is typically used for pain relief or fever reduction, not for the treatment of symptoms that may indicate a heart attack. It does not address the potential underlying cause, which is more serious.

D. Administer ibuprofen: Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) that may provide pain relief but is not appropriate for a suspected myocardial infarction. NSAIDs can also potentially increase the risk of cardiovascular events and would not be suitable in this context.

A. Chloride 99 mEq/L B. Calcium 10 mg/dL C. Sodium 136 mEq/L D. Potassium 2.3 mEq/L

Correct Answer is D

Explanation

A. Chloride 99 mEq/L: A chloride level of 99 mEq/L is within the normal range (96-106 mEq/L) and is not typically a cause for concern. It does not indicate any significant imbalance that would require immediate attention.

B. Calcium 10 mg/dL: A calcium level of 10 mg/dL is within the normal range (8.5-10.5 mg/dL). Hydrochlorothiazide can cause hypercalcemia, but a level of 10 mg/dL is still within acceptable limits and not alarming.

C. Sodium 136 mEq/L: A sodium level of 136 mEq/L is within the normal range (135-145 mEq/L). While hydrochlorothiazide can cause electrolyte imbalances, this sodium level does not indicate hyponatremia or hypernatremia and is not a critical finding.

D. Potassium 2.3 mEq/L: A potassium level of 2.3 mEq/L is significantly below the normal range (3.5-5.0 mEq/L) and indicates severe hypokalemia. This is a critical finding that needs to be reported because low potassium levels can lead to dangerous cardiac arrhythmias and other complications.

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

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