A nurse is caring for a client who is experiencing diabetic ketoacidosis (DKA). Which of the following is the priority intervention by the nurse?

Check potassium levels.

Administer 0.9% sodium chloride.

Begin bicarbonate continuous IV infusion.

Initiate a continuous IV insulin infusion.

Answer and Explanation

The Correct Answer is B

A. Checking potassium levels is important in the management of DKA, but it is not the priority intervention. Potassium levels should be monitored closely, as insulin therapy can lower potassium levels, but the first step in treatment is fluid resuscitation.

B. Administering 0.9% sodium chloride (normal saline) is the priority intervention in DKA. This helps to correct dehydration and restore circulatory volume, which is critical in stabilizing the client. Fluid replacement is the first step in managing DKA before insulin is administered.

C. Beginning bicarbonate continuous IV infusion is typically not recommended unless the pH is extremely low (below 6.9). The primary treatment in DKA is fluid and insulin therapy, and bicarbonate is used only in severe cases of acidosis.

D. Initiating a continuous IV insulin infusion is essential in treating DKA, but it should be done after initial fluid resuscitation. Insulin therapy lowers blood glucose and helps to resolve ketosis, but fluid replacement is the first priority to stabilize the client.

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Correct Answer is A

Explanation

A. Decreased blood pressure is a key indicator of dehydration. When a client is dehydrated, there is a reduction in circulating blood volume, which can lead to hypotension. This is a common sign of dehydration, especially in cases of gastroenteritis where fluid loss occurs through vomiting and diarrhea.

B. Pitting, dependent edema is more commonly associated with fluid retention or conditions like heart failure or kidney disease, not dehydration. Dehydration typically results in fluid volume deficit, not excess fluid retention.

C. Distended jugular veins are usually indicative of fluid overload, not dehydration. This is often seen in conditions like heart failure, where the body cannot effectively manage fluid volume.

D. Increased blood pressure is not typically a sign of dehydration. Dehydration tends to lead to decreased blood pressure due to reduced blood volume.

A. Hypoglycemia B. Increased muscle mass C. Increased libido D. Hot flashes

Correct Answer is D

Explanation

A. Hypoglycemia is not typically associated with a bilateral orchiectomy. The removal of the testes leads to decreased production of testosterone, which can cause other symptoms but not hypoglycemia.

B. Increased muscle mass is unlikely after a bilateral orchiectomy. The removal of the testes results in lower testosterone levels, which can lead to a decrease in muscle mass over time.

C. Increased libido is unlikely after a bilateral orchiectomy. The procedure reduces testosterone production, which generally leads to a decrease in libido.

D. Hot flashes are a common symptom following a bilateral orchiectomy due to the sudden drop in testosterone levels. This is similar to the symptoms women experience during menopause due to hormonal changes.

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A nurse is caring for a client who is experiencing diabetic ketoacidosis (DKA). Which of the following is the priority intervention by the nurse?

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Naxlex Comprehensive Predictor Exams

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