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: This is not a correct instruction for the nurse to include in the teaching. Emphasizing the quantity, rather than the quality, of food consumed may lead to overeating, obesity, or malnutrition. The nurse should encourage the mother to offer a variety of healthy foods in appropriate portions and avoid forcing or bribing the child to eat.
Choice B reason: This is not a correct instruction for the nurse to include in the teaching. Expecting that food consumption might not decrease significantly may cause the mother to ignore the signs of poor nutrition or growth in the child. The nurse should advise the mother to monitor the child's weight, height, and development regularly and consult the provider if there are any concerns.
Choice C reason: This is a correct instruction for the nurse to include in the teaching. Adding fruit juice to the child's diet can increase the vitamin intake, especially vitamin C, which is important for immune function and wound healing. The nurse should recommend the mother to choose 100% fruit juice and limit the amount to 4 to 6 oz per day.
Choice D reason: This is not a correct instruction for the nurse to include in the teaching. Having the child remain at the table after meals to increase food intake may create a negative association with eating and cause more resistance or frustration. The nurse should suggest the mother to make mealtime a pleasant and relaxed experience and respect the child's appetite and preferences.
Correct Answer is D
Explanation
Choice A reason: Herpes simplex is a viral infection that causes painful blisters or ulcers in the mouth or on the lips. It does not cause a white, milky plaque that does not come off with rubbing.
Choice B reason: Dermatitis is a skin inflammation that causes redness, itching, and scaling. It does not affect the mouth or cause a white, milky plaque that does not come off with rubbing.
Choice C reason: Squamous cell carcinoma is a type of skin cancer that develops from the squamous cells that line the mouth and other parts of the body. It causes a hard, irregular, or ulcerated growth that may bleed or become infected. It does not cause a white, milky plaque that does not come off with rubbing.
Choice D reason: Candidiasis, also known as oral thrush, is a fungal infection that causes a white, milky plaque that coats the tongue, cheeks, and roof of the mouth. It can be scraped off, but may leave a red, sore, or bleeding surface. It is more common in people who have a weakened immune system, such as those who take antibiotics, immunosuppressants, or corticosteroids. It can also be triggered by smoking, dry mouth, or poor oral hygiene.
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