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 B
Explanation
Since the patient's pre meal blood sugar is 311 mg/dL, according to the sliding scale, the patient requires 8 units of Humalog insulin. Therefore, the nurse should administer 8 units of Humalog insulin before the patient's meal. It is important to note that if the patient's blood glucose level is greater than 400 mg/dL, the nurse should call the MD instead of administering insulin. Keeping the patient NPO (nothing by mouth) is not necessary in this situation, as the patient is awake, alert, and able to swallow, and will require their meal for adequate nutrition. However, it is important to monitor the patient's blood glucose level after administering insulin and adjust the dosage if necessary.
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