Cardiac monitoring is initiated for a patient with diabetic ketoacidosis. The nurse determines that this measure is important to identify:

Electrocardiographic (ECG) changes and dysrhythmias related to hypokalemia.

The presence of hypovolemic shock related to osmotic diuresis.

Cardiovascular collapse resulting from the eﬀects of hyperglycemia.

Fluid overload resulting from aggressive ﬂuid replacement.

Answer and Explanation

The Correct Answer is A

Electrocardiographic (ECG) changes and dysrhythmias related to hypokalemia are the main reasons for initiating cardiac monitoring in patients with diabetic ketoacidosis. In diabetic ketoacidosis, insulin deficiency causes the body to break down fat for energy, leading to the production of ketones and resulting in metabolic acidosis. In addition, glucose and potassium are lost in the urine due to osmotic diuresis. Hypokalemia can cause ECG changes and dysrhythmias, which can be life-threatening.

Hypokalemia is a common complication of DKA and can lead to ECG changes such as ST-segment depression, T-wave inversion, and U waves².

Hypovolemic shock related to osmotic diuresis is an important consideration in the management of diabetic ketoacidosis, but it is not the primary reason for initiating cardiac monitoring.

Cardiovascular collapse resulting from the eﬀects of hyperglycemia is not a common complication of diabetic ketoacidosis, and it is not the primary reason for initiating cardiac monitoring.

Fluid overload resulting from aggressive ﬂuid replacement is a potential complication of diabetic ketoacidosis, but it is not the primary reason for initiating cardiac monitoring.

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Correct Answer is A

Explanation

This meal choice is low in sodium as it contains fresh ingredients and does not include processed or pre-packaged foods that are typically high in sodium. Chicken, bread, and carrots are naturally low in sodium, and the client can control the amount of added salt or seasoning. In contrast, the other food choices are likely to be high in sodium due to added salt, cheese, or processed ingredients.

Therefore, the nurse should encourage the client to choose fresh, low-sodium foods and avoid processed or pre-packaged meals.

A. encourage the patient to drink at least 3000 ml of ﬂuid a day. B. suggest that the patient increase dietary intake of foods that are high in fiber. C. inform the patient that a daily bowel movement is not necessary. D. perform a focused nursing assessment to identify risk factors for constipation.

Correct Answer is D

Explanation

Although increasing ﬂuid intake and fiber intake are important interventions for preventing constipation, it is important to first assess the patient's current situation and risk factors for constipation. Additionally, while a daily bowel movement is not necessary for everyone, it is important to understand the patient's usual bowel habits and whether or not their current regimen is eﬀective for them. Therefore, the nurse should perform a focused nursing assessment to identify the patient's risk factors for constipation and evaluate their current bowel regimen before providing specific interventions or recommendations.

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Cardiac monitoring is initiated for a patient with diabetic ketoacidosis. The nurse determines that this measure is important to identify:

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