A patient with diabetic ketoacidosis is brought to the emergency department. Which prescribed action should the nurse implement first?
Bring the patient a meal.
Administer Lantus insulin IV.
Give sodium bicarbonate 50 mEq IV push.
Start an infusion of normal saline at 125 ml/hr.
The Correct Answer is D
Diabetic ketoacidosis (DKA) is a serious complication of diabetes that occurs when the body produces high levels of blood acids called ketones. The initial management of DKA involves fluid resuscitation with intravenous normal saline to correct dehydration and electrolyte imbalances. Therefore, starting an infusion of normal saline at 125 ml/hr is the first prescribed action the nurse should implement.
Bringing the patient a meal is not a priority at this time because the patient's blood glucose levels need to be stabilized before they can safely consume food. Administering Lantus insulin IV and giving sodium bicarbonate 50 mEq IV push are also not the first-line treatments for DKA. Lantus insulin is a long-acting insulin used to treat hyperglycemia over an extended period and should not be given intravenously. Sodium bicarbonate may be used to correct acidosis, but it is not the first priority in DKA management.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Therefore, the correct option is d. Glyburide is a sulfonylurea medication used to treat type 2 diabetes. It works by stimulating the beta cells in the pancreas to produce and release more insulin, which helps to lower blood glucose levels.
Option A is incorrect because glyburide does not affect glucagon secretion from the pancreas. Glucagon is a hormone that raises blood glucose levels by promoting the breakdown of glycogen in the liver.
Option b is incorrect because glyburide should not be taken if the morning blood glucose level is less than 70 mg/dL, as this may increase the risk of hypoglycemia.
Option c is incorrect because glyburide does not interact with IV contrast media. However, some types of IV contrast media can cause kidney damage in patients with diabetes, and the use of glyburide should be temporarily discontinued if a patient is undergoing a procedure that involves the use of contrast media.
Correct Answer is D
Explanation
The nurse should quickly assess the patient's vital signs to check for signs of shock and instability. If the vital signs are unstable, the nurse should initiate appropriate interventions to stabilize the patient, such as administering oxygen, starting IV fluids, and providing continuous cardiac monitoring. Based on the sudden onset of severe upper abdominal pain, diaphoresis, and a firm abdomen, the nurse should suspect a possible perforation or bleeding related to the peptic ulcer. This is a medical emergency that requires immediate intervention. Therefore, the nurse should prioritize notifying the healthcare provider and preparing the patient for urgent medical evaluation.
Option A, irrigating the NG tube, is not appropriate in this situation and may further exacerbate the patient's condition if the ulcer has perforated.
Option B, elevating the foot of the bed, is also not appropriate as it does not address the patient's current symptoms.
Option C, giving the ordered antacid, may not be effective in addressing the severity of the patient's symptoms and should be postponed until the healthcare provider has evaluated the patient.
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