A patient is admitted to the hospital with hyperosmolar hyperglycemia. The patient has a BG value of 987 mg/dL. Which is the priority focus while providing care?
Identifying age-related changes
Monitoring BG level
Establishing the presence of an illness
Improving hydration status
The Correct Answer is D
D. The priority focus in the acute management of hyperosmolar hyperglycemia is improving hydration status. Patients with HHS are severely dehydrated due to the osmotic diuresis caused by extremely high blood glucose levels. Rapid rehydration is critical to prevent shock, improve organ perfusion, and reduce blood glucose levels.
A. It's important to consider age-related changes in any patient but this is not the immediate priority in the acute management of hyperosmolar hyperglycemia. The primary concern is addressing the acute, life-threatening aspects of the condition.
B. Monitoring blood glucose levels is critical in managing hyperosmolar hyperglycemia. However, while it is essential to track the BG levels to guide insulin therapy and assess the response to treatment, it is not the immediate priority in terms of interventions needed to stabilize the patient initially.
C. Determining the underlying cause of hyperosmolar hyperglycemia, such as an infection or other illness, is important for comprehensive treatment. However, it is a secondary priority to stabilizing the patient’s current acute condition.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["2.5"]
Explanation
Volume= Desired dose/ Available concentration per ml Available concentration per ml= 40mg/ 5ml
Available concentration= 8mg/ml Desired dose= 20mg
Volume= 20mg/ 8mg Volume= 2.5ml
Therefore, the nurse should administer 2.5ml of famotidine.
Correct Answer is ["A","C","F","G"]
Explanation
A. Acetone breath, characterized by a fruity or acetone-like odor on the patient's breath, is a classic sign of DKA. In addition, Kussmaul respirations, which are deep and labored breathing patterns, can occur as the body attempts to compensate for metabolic acidosis in DKA.
C. Nausea and vomiting are common symptoms of DKA and can occur due to metabolic acidosis, electrolyte imbalances, and gastrointestinal disturbances associated with the condition.
F. Tachycardia and hypotension are signs of hemodynamic instability, which can occur in severe cases of DKA due to dehydration, electrolyte imbalances, and the systemic effects of metabolic acidosis.
G. Turning off an insulin pump can lead to insulin deficiency, which is a precipitating factor for DKA, particularly in patients with type 1 diabetes who rely on continuous insulin therapy. This finding is consistent with the development of DKA.
B. Blurred vision and headache can be symptoms of DKA, although they are not specific to this condition. Elevated blood glucose levels and dehydration associated with DKA can lead to osmotic diuresis and subsequent fluid shifts, which may manifest as headache and visual disturbances.
D. A history of type 1 diabetes mellitus (DM) predisposes the patient to DKA but the history of appendix removal at age 7 is not directly relevant to the current presentation of DKA.
E. Alcohol ingestion can contribute to the development of DKA by inhibiting gluconeogenesis and promoting ketoacidosis, particularly if the patient is not consuming adequate carbohydrates and insulin. However, it is not a direct sign of DKA.
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