A nurse is caring for an adolescent who has been diagnosed with diabetic ketoacidosis (DKA). The nurse notes the following:
When planning care for this client, the nurse should anticipate a provider's prescription for which of the following?
Insulin therapy and fluid replacement
Glucagon injection and potassium supplements
Bicarbonate infusion and sodium restriction
Dextrose infusion and diuretics
The Correct Answer is A
Choice A reason: Insulin therapy and fluid replacement are the main treatments for DKA, as they lower the blood glucose level and correct the dehydration and electrolyte imbalance caused by osmotic diuresis and acidosis.
Choice B reason: Glucagon injection and potassium supplements are not indicated for DKA, as they may worsen the hyperglycemia and the hyperkalemia. Glucagon stimulates the liver to release more glucose into the bloodstream, while potassium supplements may increase the risk of cardiac arrhythmias.
Choice C reason: Bicarbonate infusion and sodium restriction are not the first-line treatments for DKA, as they may have adverse effects on the acid-base balance and the fluid status. Bicarbonate infusion may cause paradoxical cerebral acidosis and hypokalemia, while sodium restriction may exacerbate the hyponatremia and the hypovolemia.
Choice D reason: Dextrose infusion and diuretics are contraindicated for DKA, as they may increase the blood glucose level and the dehydration. Dextrose infusion may trigger a rebound hyperglycemia, while diuretics may cause further fluid and electrolyte loss.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason: A 2-year-old toddler is not a recommended recipient of the MCV4 vaccine, as it is not routinely given to children younger than 11 years old, unless they have certain medical conditions that increase their risk of meningococcal disease, such as asplenia, complement deficiency, or HIV infection. A 2-year-old toddler may receive the meningococcal polysaccharide (MPSV4) vaccine instead, if indicated.
Choice B reason: A 4-month-old infant is not a recommended recipient of the MCV4 vaccine, as it is not routinely given to children younger than 11 years old, unless they have certain medical conditions that increase their risk of meningococcal disease, such as asplenia, complement deficiency, or HIV infection. A 4-month-old infant may receive the meningococcal serogroup B (MenB) vaccine instead, if indicated.
Choice C reason: An 11-year-old school-age child is a recommended recipient of the MCV4 vaccine, as it is routinely given to children aged 11 to 12 years old, with a booster dose at age 16. The MCV4 vaccine protects against four types of meningococcal bacteria (A, C, W, and Y) that can cause serious infections of the lining of the brain and spinal cord (meningitis) or the bloodstream (septicemia).
Choice D reason: A 4-year-old child is not a recommended recipient of the MCV4 vaccine, as it is not routinely given to children younger than 11 years old, unless they have certain medical conditions that increase their risk of meningococcal disease, such as asplenia, complement deficiency, or HIV infection. A 4-year-old child may receive the meningococcal polysaccharide (MPSV4) vaccine instead, if indicated.
Correct Answer is C
Explanation
Choice A reason: Acetaminophen suppository is not a likely prescription, as it is used to reduce fever and pain, which are not the main problems of the toddler. The toddler has a high axillary temperature of 39.5°C (103.1°F), which is not considered a fever in children under 2 years old. The normal axillary temperature range for children is 36.5°C to 37.5°C (97.7°F to 99.5°F).
Choice B reason: Oral rehydration solution is not a probable prescription, as it is used to prevent or treat dehydration caused by diarrhea, vomiting, or excessive sweating, which are not the main problems of the toddler. The toddler has a normal respiratory rate of 22/min and oxygen saturation of 98%, which indicate adequate hydration and oxygenation.
Choice C reason: Nebulized albuterol is a possible prescription, as it is used to treat bronchospasm, which is a common complication of respiratory infections in children. The toddler has a high apical heart rate of 142/min, which may indicate respiratory distress or hypoxia. The toddler is also pulling at his ear, which may indicate an ear infection or pain.
Choice D reason: Intravenous antibiotics are not a likely prescription, as they are used to treat bacterial infections, which are not the main problems of the toddler. The toddler has no signs or symptoms of a bacterial infection, such as purulent discharge, foul odor, or localized inflammation. The toddler may have a viral infection, which does not respond to antibiotics.
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