A nurse is caring for a client who has metabolic acidosis due to diabetic ketoacidosis (DKA) Which of the following manifestations should the nurse monitor?

Kussmaul respirations.

Bradypnea.

Muscle spasms.

Numbness and tingling of extremities.

Answer and Explanation

The Correct Answer is A

Choice A reason:

Kussmaul respirations are a type of deep, rapid breathing that occurs in response to metabolic acidosis. The body tries to compensate for the excess acid by blowing off carbon dioxide through the lungs. Kussmaul respirations are a common manifestation of diabetic ketoacidosis (DKA), which is a severe form of metabolic acidosis caused by the accumulation of ketones in the blood. The nurse should monitor the client's respiratory rate, depth, and pattern, as well as the arterial blood gas results, to assess the severity of metabolic acidosis and the effectiveness of treatment.

Choice B reason:

Bradypnea is a condition of abnormally slow breathing, usually less than 12 breaths per minute. Bradypnea can result from respiratory acidosis, which is a condition of excess carbon dioxide in the blood due to hypoventilation or impaired gas exchange. Bradypnea is not a manifestation of metabolic acidosis, which is a condition of excess acid in the blood due to increased production or decreased elimination of hydrogen ions. Therefore, choice B is incorrect.

Choice C reason:

Muscle spasms are involuntary contractions of the skeletal muscles that can cause pain and discomfort. Muscle spasms can result from hypocalcemia, which is a condition of low calcium levels in the blood. Hypocalcemia can occur in metabolic acidosis due to the binding of calcium with excess hydrogen ions, reducing the availability of free calcium for muscle contraction. However, muscle spasms are not a specific or common manifestation of metabolic acidosis, and they can have other causes such as dehydration, electrolyte imbalance, or muscle injury. Therefore, choice C is incorrect.

Choice D reason:

Numbness and tingling of extremities are sensations of reduced or abnormal feeling in the arms or legs. Numbness and tingling can result from hypokalemia, which is a condition of low potassium levels in the blood. Hypokalemia can occur in metabolic acidosis due to the movement of potassium from the intracellular to the extracellular space in exchange for hydrogen ions, which are then excreted by the kidneys. However, numbness and tingling are not specific or common manifestations of metabolic acidosis, and they can have other causes such as nerve compression, peripheral neuropathy, or hyperventilation. Therefore, choice D is incorrect.

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Correct Answer is ["A","B","D","E"]

Explanation

Choice A reason:

Administer the solution via a central line. This is correct because 3% sodium chloride solution is a hypertonic solution that can cause phlebitis and tissue damage if infused peripherally. A central line can deliver the solution more safely and effectively.

Choice B reason:

Monitor serum sodium levels every 4 hours. This is correct because serum sodium levels can indicate the effectiveness of the therapy and the risk of complications such as hypernatremia or cerebral edema. The normal range of serum sodium is 135 to 145 mEq/L.

Choice C reason:

Titrate the infusion rate according to urine output. This is incorrect because the infusion rate of 3% sodium chloride solution should be titrated according to serum sodium levels, not urine output. Urine output can be affected by other factors such as renal function, fluid intake, and diuretics.

Choice D reason:

Assess for signs of fluid overload. This is correct because 3% sodium chloride solution can cause fluid shifts from the intracellular and interstitial spaces to the intravascular space, leading to fluid overload. Signs of fluid overload include cough, dyspnea, crackles, tachypnea, tachycardia, elevated blood pressure, bounding pulse, elevated central venous pressure (CVP), weight gain, edema, neck and hand vein distention, altered level of consciousness, and decreased hematocrit.

Choice E reason:

Keep an accurate intake and output record. This is correct because intake and output records can help monitor the fluid balance and identify any excesses or deficits. Intake includes oral fluids, intravenous fluids, tube feedings, and blood products. Output includes urine, stool, vomitus, drainage, and insensible losses.

A. Decreased serum pH. B. Increased serum calcium. C. Decreased serum magnesium. D. Increased serum bicarbonate.

Correct Answer is C

Explanation

Choice A: Decreased serum pH. This is incorrect because hypokalemia usually causes increased serum pH, not decreased. This is because low potassium levels can lead to metabolic alkalosis, a condition where the blood is too alkaline due to loss of acid from the body. This can happen in cases of vomiting, diuretic use, or mineralocorticoid excess.

Choice B:

Increased serum calcium. This is incorrect because hypokalemia does not directly affect serum calcium levels. However, hypokalemia can cause hypomagnesemia, or low magnesium levels, which can in turn cause hypercalcemia, or high calcium levels. This is because magnesium is needed for the secretion of parathyroid hormone (PTH), which regulates calcium balance in the body. Low magnesium levels can lead to increased PTH secretion and increased calcium reabsorption from the bones and kidneys.

Choice C:

Decreased serum magnesium. This is correct because hypokalemia and hypomagnesemia often occur together, especially in cases of chronic diarrhea, malabsorption, alcoholism, or diuretic use. This is because potassium and magnesium are both lost in the urine or stool when these conditions are present. Hypomagnesemia can also cause hypokalemia by impairing the reabsorption of potassium in the kidneys and increasing the entry of potassium into the cells.

Choice D:

Increased serum bicarbonate. This is incorrect because hypokalemia usually causes decreased serum bicarbonate, not increased. This is because low potassium levels can lead to metabolic acidosis, a condition where the blood is too acidic due to accumulation of acid in the body. This can happen in cases of diabetic ketoacidosis, renal tubular acidosis, or chronic kidney disease.

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A nurse is caring for a client who has metabolic acidosis due to diabetic ketoacidosis (DKA) Which of the following manifestations should the nurse monitor?

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Naxlex Comprehensive Predictor Exams

A nurse is planning care for a client who has hyponatremia and is receiving IV fluid therapy with 3% sodium chloride solution. Which of the following interventions should the nurse include in the plan? (Select all that apply.)

Correct Answer is ["A","B","D","E"]

Explanation

A nurse is reviewing laboratory results for a client who has hypokalemia. Which of the following findings should the nurse expect?

Correct Answer is C

Explanation

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