A patient recovering from surgery has an indwelling urinary catheter. For which 24-hour urine output volumes should the nurse notify the patient's healthcare provider?

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.

Hypernatremia.

Choice A rationale:

Hypernatremia is the most likely condition the client is experiencing based on the laboratory result of Sodium 144 mEq/L, which is above the normal range of 136 to 145 mEq/L. Hypernatremia is an elevated sodium level in the blood and can cause various symptoms like extreme thirst, dry mucous membranes, and altered mental status.

Choice B rationale:

To address hypernatremia, the nurse should take two actions. Action 1: Prepare to check a serum albumin level. This is important as hypernatremia can be caused by a relative water deficit due to excess solutes, and measuring serum albumin helps assess the body's water balance. Action 2: Request a STAT ECG. Hypernatremia can lead to cardiac arrhythmias, so an ECG is essential to monitor the patient's heart rhythm. Parameters to Monitor: Parameter 1 - Serum bicarbonate level: Monitoring bicarbonate levels helps evaluate acid-base balance and assess the impact of hypernatremia on the body's buffering systems. Parameter 2 - Intake and Output: Monitoring the patient's fluid intake and output is crucial to ensure proper hydration and track response to treatment.