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.
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
The patient has been diagnosed with type 2 diabetes and reports following a reduced-calorie diet but has not lost any weight. This suggests that the patient may not be following the diet as prescribed or may have other factors affecting their blood glucose levels. Additionally, the patient did not bring their glucose monitoring record, which is an important tool for assessing blood glucose control over time.
In this situation, obtaining a fasting blood glucose level or an oral glucose tolerance test may provide a snapshot of the patient's blood glucose level at the time of the test, but these tests do not provide information about blood glucose control over the past few months. A urine dipstick for glucose is a less reliable method for assessing blood glucose control and is not recommended for routine monitoring.
Therefore, obtaining a glycosylated hemoglobin (HbA1c) level is the most appropriate test in this situation. HbA1c reflects the average blood glucose level over the past 2-3 months and is recommended for routine monitoring of blood glucose control in patients with diabetes. This test can provide valuable information about the effectiveness of the patient's diet and any other interventions aimed at controlling their blood glucose levels.
Correct Answer is A
Explanation
Based on the given arterial blood gas results, the patient's pH is elevated, indicating alkalosis. The PaCO2 level is decreased, which suggests respiratory compensation. The bicarbonate (HCO3-) level is within the normal range. Therefore, the interpretation of the arterial blood gas results is respiratory alkalosis.
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