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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
The most helpful finding by the nurse in determining whether a 67-yr-old patient with benign prostatic hyperplasia has an upper urinary tract infection (pyelonephritis) would be
**costovertebral tenderness**⁴. This is because costovertebral tenderness is a common symptom of pyelonephritis⁵. Pyelonephritis is an infection of the upper urinary tract that can cause fever, chills, flank pain, nausea, vomiting, and costovertebral tenderness⁵. Foul-smelling urine and bladder distention are not specific symptoms of pyelonephritis⁵. Suprapubic discomfort can be a symptom of lower urinary tract infection⁵.
Correct Answer is ["A","D","E"]
Explanation
Option A indicates that the client understands the timing of glyburide administration, which is typically taken with the first bite of a meal to aid in glucose control.
Option d indicates that the client understands the importance of continuing antidiabetic medications even when they are sick. Skipping doses during illness can lead to uncontrolled blood glucose levels.
Option e indicates that the client understands the importance of foot care in preventing complications related to peripheral neuropathy, such as diabetic foot ulcers.
Option b is incorrect because patients with peripheral neuropathy should not walk barefoot, as they may not feel injuries to their feet, which can lead to diabetic foot ulcers and other complications.
Option c is incorrect because antidiabetic medications do not allow patients to eat whatever they desire. Patients with diabetes need to follow a healthy diet and exercise plan to manage their blood glucose levels effectively.
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