A patient newly diagnosed with diabetes mellitus is admitted to the emergency department with nausea, vomiting, and abdominal pain. ABG results reveal a pH of 7.2 and a bicarbonate level of 20 mEq/L. What other assessment findings should the nurse anticipate in this patient? Select all that apply.

Dysrhythmias.

Kussmaul respirations.

Weakness.

Cold, clammy skin.

Answer and Explanation

Correct Answer : B,C,E

Choice A rationale:

Dysrhythmias are not a direct consequence of diabetic ketoacidosis (DKA) or the acid-base imbalance indicated by the patient's pH of 7.2 and bicarbonate level of 20 mEq/L. DKA primarily affects the respiratory system, leading to Kussmaul respirations, not dysrhythmias.

Choice B rationale:

Kussmaul respirations are an expected finding in a patient with diabetic ketoacidosis (DKA) and metabolic acidosis. These deep, rapid breaths are the body's attempt to compensate for the acidosis by eliminating excess CO2.

Choice C rationale:

Weakness is a common symptom of DKA. The hyperglycemia and acidosis result in intracellular dehydration and impaired cellular function, leading to weakness and fatigue.

Choice D rationale:

Cold, clammy skin is not typically associated with DKA. Instead, patients with DKA may have warm, dry skin due to dehydration and impaired thermoregulation.

Choice E rationale:

Tachycardia is an expected finding in a patient with DKA. The metabolic acidosis and dehydration lead to an increase in heart rate as the body attempts to maintain perfusion.

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Correct Answer is ["A","B","C"]

Explanation

Choice A rationale:

The nurse considered contraction of facial muscles as a finding of hypocalcemia because it is associated with Chvostek's sign, which indicates neuromuscular irritability due to low calcium levels.

Choice B rationale:

Complaints of fingers tingling are indicative of hypocalcemia since tingling sensations (paresthesias) in the extremities can result from decreased calcium levels affecting nerve function.

Choice C rationale:

Carpal spasm with blood pressure measurement is known as Trousseau's sign and is associated with hypocalcemia. When the blood pressure cuff is inflated above systolic pressure, it can cause tetany in the hand if the calcium levels are low.

Choice D rationale:

Asking when foot numbness would go away does not directly relate to hypocalcemia or its symptoms. It is not a finding used to come to the conclusion of hypocalcemia in this scenario.

Choice E rationale:

The heart rate being 88 and regular does not directly indicate hypocalcemia. While hypocalcemia can lead to cardiac arrhythmias, a heart rate of 88 and regular is within the normal range and not a specific finding for hypocalcemia.

A. Hyperactive deep tendon reflexes. B. Warm, flushed skin. C. Widened QRS Complexes. D. Bounding peripheral pulses.

Correct Answer is C

Explanation

Widened QRS Complexes.

Choice A rationale:

Hyperactive deep tendon reflexes are not typical findings in respiratory acidosis. They are more commonly associated with conditions like hypocalcemia or hypercalcemia.

Choice B rationale:

Warm, flushed skin is not directly related to respiratory acidosis. It is not a typical manifestation of this acid-base imbalance.

Choice C rationale:

Widened QRS complexes on an ECG are characteristic findings in respiratory acidosis. Acidosis can lead to changes in the electrical conduction of the heart, resulting in QRS complex widening.

Choice D rationale:

Bounding peripheral pulses are not directly associated with respiratory acidosis. They may be seen in conditions like hyperthyroidism or anemia but are not specific to respiratory acidosis. Remember, always interpret lab results and clinical findings in the context of the patient's overall condition, medical history, and other relevant factors to provide the best care possible.

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A patient newly diagnosed with diabetes mellitus is admitted to the emergency department with nausea, vomiting, and abdominal pain. ABG results reveal a pH of 7.2 and a bicarbonate level of 20 mEq/L. What other assessment findings should the nurse anticipate in this patient? Select all that apply.

Nursing Test Bank

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