A nurse is providing care for a client who has diabetes mellitus. Which of the following laboratory findings indicates the client most likely to be diagnosed with diabetic ketoacidosis (DKA)?
Serum sodium 140 mg/dL
Blood urea nitrogen (BUN) 18 mg/dL
Serum bicarbonate less than 15
Arterial blood pH 7.46
The Correct Answer is C
A. Serum sodium 140 mg/dL: This is a normal sodium level and does not provide diagnostic information specific to DKA. Sodium may fluctuate in DKA but is not a defining lab value for the condition.
B. Blood urea nitrogen (BUN) 18 mg/dL: This BUN level is within normal limits. Although BUN can be elevated in DKA due to dehydration, a normal value does not support the diagnosis of DKA on its own.
C. Serum bicarbonate less than 15: A low bicarbonate level indicates metabolic acidosis, which is a key diagnostic feature of DKA. It reflects the buffering of excess ketone acids in the blood, making this a highly specific indicator.
D. Arterial blood pH 7.46: This value is slightly alkalotic and inconsistent with DKA, which is characterized by metabolic acidosis and a pH usually below 7.3. Elevated pH would suggest another acid-base disorder.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. Deep vein thrombosis (DVT): Although clients with increased intracranial pressure may be at risk for DVT, this is not the primary concern in the first 24-48 hours. Early enteral nutrition helps prevent gastrointestinal complications, such as bacterial translocation, which can be more immediate and serious.
B. Myocardial infarction: Myocardial infarction is unrelated to the timing of enteral nutrition in clients with increased intracranial pressure. The priority here is to address risks related to the gut and the immune system.
C. Pulmonary embolus: A pulmonary embolus is a serious condition, but is not the most direct consequence of delayed enteral nutrition. While immobility and other factors might increase the risk of embolism, bacterial translocation is the immediate concern.
D. Bacterial translocation: Early enteral nutrition is crucial for maintaining gut integrity and preventing bacterial translocation, which occurs when bacteria from the gut leak into the bloodstream. This can lead to systemic infections and sepsis, which are life-threatening complications in critically ill clients.
Correct Answer is C
Explanation
A. A client who has coronary artery disease (CAD) and chronic allergies: While chronic allergies can affect respiratory health, they are not as significant a risk factor for complications following CABG surgery as pulmonary diseases like COPD, which directly impact lung function and oxygenation during recovery.
B. A client who has coronary artery disease (CAD) and Bell's palsy: Bell's palsy, a condition that causes temporary facial paralysis, is not directly related to increased risk for complications following CABG surgery. The primary concern following surgery would be more related to cardiovascular and respiratory health rather than neurological conditions like Bell's palsy.
C. A client who has coronary artery disease (CAD) and chronic obstructive pulmonary disease (COPD): COPD significantly increases the risk of complications after CABG surgery due to the impact on lung function. Patients with COPD have reduced oxygenation capacity, making them more vulnerable to respiratory complications such as pneumonia, atelectasis, or prolonged mechanical ventilation.
D. A client who has coronary artery disease (CAD) and chronic diverticulitis: Chronic diverticulitis affects the gastrointestinal system and is generally not a major risk factor for complications following CABG surgery. The client may have a higher risk for GI issues, but respiratory and cardiovascular factors play a more significant role in CABG recovery.
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