A patient is post-op from knee surgery. The patient has been receiving Morphine 4 mg IV every 2 hours. The nurse notices the patient is exhibiting a respiratory rate of 8 and is extremely drowsy. Which of the following conditions is the patient at risk for?

Respiratory acidosis

Hypokalemia

Metabolic acidosis

Respiratory alkalosis

Answer and Explanation

The Correct Answer is A

A. Respiratory acidosis:
This occurs when there is inadequate removal of carbon dioxide (CO2) by the respiratory system. In the case of the patient post-op from knee surgery receiving Morphine, the opioid can cause respiratory depression, leading to the retention of CO2 and the development of respiratory acidosis. Signs include a decreased respiratory rate and drowsiness.

B. Hypokalemia:
This is a condition characterized by low levels of potassium in the blood. While opioids can cause constipation, they are not directly associated with hypokalemia.

C. Metabolic acidosis:
This occurs when there is an increase in acid production or a loss of bicarbonate, leading to an imbalance in the body's acid-base status. The symptoms of metabolic acidosis are not typically associated with opioid use.

D. Respiratory alkalosis:
This occurs when there is excessive elimination of CO2, leading to decreased carbon dioxide levels in the blood. Opioids, especially in higher doses, are more likely to cause respiratory depression and acidosis rather than alkalosis. The patient's low respiratory rate and drowsiness are indicative of respiratory acidosis rather than alkalosis.

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Correct Answer is A

Explanation

A. Stress has likely caused an increase in the client's blood sugar levels:
This statement is accurate. Stress, especially related to surgery, can lead to increased levels of stress hormones, such as cortisol and catecholamines, which can elevate blood sugar levels. Surgery is a physiological stressor that can impact glucose metabolism.

B. The client's volatile fluid balance surrounding surgery has likely caused unstable blood sugars:
This is the most appropriate choice. Surgery, anesthesia, and changes in fluid balance can affect blood glucose levels. The stress response to surgery can lead to fluctuations in blood sugar, and patients may need insulin during this period.

C. The client has likely overstimulated her ability to control her diabetes using non-pharmacologic measures:
This statement is not accurate. Overstimulation is not a common cause of the need for insulin in the context of surgery. The stress and physiological changes associated with surgery are more likely contributors.

D. Alterations in bile metabolism and release have likely caused hyperglycemia:
While alterations in metabolism can impact glucose regulation, in the context of surgery, the primary factors are the stress response, changes in fluid balance, and potential alterations in the ability to eat or drink normally rather than specific effects on bile metabolism.

A. It is rapidly absorbed, has a fast onset of action B. Administer the total daily dosage in two doses C. Draw up the drug first, then add regular insulin D. Do not mix with other insulins

Correct Answer is D

Explanation

A. It is rapidly absorbed, has a fast onset of action:
Explanation: This statement is incorrect. Glargine (Lantus) actually has a slow onset of action and a prolonged duration of action. It is formulated to provide a steady level of insulin in the body over an extended period.

B. Administer the total daily dosage in two doses:
Explanation: This is not the recommended administration for glargine. It is typically administered once daily to provide basal insulin coverage over a 24-hour period.

C. Draw up the drug first, then add regular insulin:
Explanation: Mixing glargine with other insulins is not recommended. Glargine should be administered separately to maintain its extended duration of action. It should not be mixed with other insulins in the same syringe.

D. Do not mix with other insulins:
Explanation: This is the correct statement. Glargine should not be mixed with other insulins. It should be administered alone to maintain its "peakless" basal coverage. Mixing it with other insulins could alter its pharmacokinetics and compromise its effectiveness.

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A patient is post-op from knee surgery. The patient has been receiving Morphine 4 mg IV every 2 hours. The nurse notices the patient is exhibiting a respiratory rate of 8 and is extremely drowsy. Which of the following conditions is the patient at risk for?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Correct Answer is A

Explanation

Which of the following should be included in the teaching plan for a patient receiving glargine (Lantus), "peakless" basal insulin?

Correct Answer is D

Explanation

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