A postoperative patient who had surgery for a perforated gastric ulcer has been receiving nasogastric suction for 3 days. The patient now has a serum sodium level of 127 mEq/L (127 mmol/L). Which prescribed therapy should the nurse question?

Choice A reason: This statement is false. Asking the patient about home insulin doses is not the action that the nurse should take first. Insulin is a hormone that lowers the blood glucose level and can also lower the blood potassium level by driving potassium into the cells. However, this is not the primary cause of hypokalemia, or low blood potassium level, which can be due to other factors such as diuretics, vomiting, diarrhea, or alkalosis.

Choice B reason: This statement is true. Administering IV potassium supplements is the action that the nurse should take first. Potassium is an electrolyte that is essential for the normal function of the heart, muscles, and nerves. Hypokalemia can cause cardiac arrhythmias, muscle weakness, and paralysis. IV potassium supplements can restore the blood potassium level and prevent life-threatening complications.

Choice C reason: This statement is false. Placing the patient on a cardiac monitor is not the action that the nurse should take first. A cardiac monitor is a device that records the electrical activity of the heart and can detect any abnormal rhythms or conduction problems. It is a useful tool for monitoring the patient's cardiac status, but it does not treat the underlying cause of hypokalemia.

Choice D reason: This statement is false. Starting an insulin infusion at 0.1 units/kg/h is not the action that the nurse should take first. Insulin infusion is a method of delivering insulin continuously through a pump or a catheter. It is used for patients with diabetes who need tight glucose control. It can also lower the blood potassium level by driving potassium into the cells. However, this is not t

Choice A reason: Performing an in/out catheterization is not a suitable method to measure urine output for a 10-month old client with dehydration. An in/out catheterization is a procedure where a catheter is inserted into the bladder through the urethra, and the urine is drained and measured. This method is invasive, painful, and carries the risk of infection and trauma. It is usually reserved for clients who have urinary retention or obstruction, or who need a sterile urine sample.

Choice B reason: Inserting a Foley catheter is also not an appropriate method to measure urine output for a 10-month old client with dehydration. A Foley catheter is a type of catheter that stays in the bladder and drains the urine into a collection bag. This method is also invasive, painful, and carries the risk of infection and trauma. It is usually used for clients who have urinary incontinence, surgery, or long-term bed rest.

Choice C reason: Collecting the client's urine in a cup is not a feasible method to measure urine output for a 10-month old client with dehydration. A cup is not a reliable or accurate device to collect and measure urine, especially for a young child who may not be toilet trained or cooperative. It is also difficult to ensure that all the urine is collected in the cup, and that the cup is not contaminated by other fluids or substances.

Choice D reason: Counting the number of wet diapers is the best method to measure urine output for a 10-month old client with dehydration. This method is non-invasive, simple, and practical. It can provide an estimate of the urine volume and frequency, and indicate the hydration status of the child. The nurse should weigh the diapers before and after use, and record the difference in grams. One gram of weight equals one milliliter of urine. The nurse should also observe the color, odor, and concentration of the urine. The normal urine output for a child is 1 to 2 mL/kg/hour.