Exhibits
Nursing actions: Indicated/contraindicated/non-urgent
Teach the client how to count carbohydrates
Stop the insulin infusion
Decrease the frequency of blood glucose tests
Start the client on a regular diet
Decrease the insulin IV infusion to 0.05 units/kg/hr
The Correct Answer is {"A":{"answers":"C"},"B":{"answers":"B"},"C":{"answers":"B"},"D":{"answers":"B"},"E":{"answers":"A"}}
A. Teach the client how to count carbohydrates - Non-urgent. While essential for long- term management of diabetes, carbohydrate counting is not immediately critical in the acute management phase of HHS in the ICU. This teaching should be delayed until the patient is stabilized.
B. Stop the insulin infusion - Contraindicated. Stopping insulin in a patient with HHS, which is characterized by severe hyperglycemia, would be harmful. Insulin therapy is critical to reduce blood glucose levels safely.
C. Decrease the frequency of blood glucose tests - Contraindicated. Frequent monitoring is crucial in managing HHS, especially when insulin therapy is being administered, to prevent hypoglycemia and to monitor the effectiveness of treatment.
D. Start the client on a regular diet - Contraindicated. Introducing a regular diet during the acute phase of HHS could exacerbate the hyperglycemia. Nutritional needs should be assessed and managed carefully, typically starting with IV fluids and gradually transitioning to enteral or oral feeding as the patient stabilizes.
E. Decrease the insulin IV infusion to 0.05 units/kg/hr- Indicated. As blood sugar levels decrease, the insulin infusion rate may be cautiously reduced to prevent hypoglycemia.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. Serum electrolytes are important to monitor in chronic kidney disease but do not directly relate to the effects of epoetin alfa.
B. Platelet count is not typically affected by epoetin alfa and does not directly address the client’s symptoms of tiredness.
C. Complete blood count (CBC) is crucial to monitor, especially hemoglobin and hematocrit levels, as epoetin alfa is used to treat anemia in chronic kidney disease, which can cause fatigue.
D. Liver enzymes are not directly related to the effects of epoetin alfa and the symptoms described.
Correct Answer is A
Explanation
A. If the PN suspects an error in a prescription, especially regarding a child's dosage, it's imperative to communicate concerns to the healthcare provider for clarification and potential adjustment.
B. While involving another nurse might provide a second opinion, it's crucial to involve the prescriber to rectify any potential prescription errors.
C. The prescription should be confirmed with the healthcare provider before any medication is dispensed or administered.
D. While seeking information from peers is valuable, this situation calls for direct clarification from the prescriber to ensure proper dosing for the child.
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