The nurse is caring for a patient admitted with hyperglycemic hyperosmolar syndrome who is receiving fluid replacement therapy with normal saline at 250 mL per hour along with a continuous insulin infusion. What potential complications of this treatment will the nurse monitor the patient for? (Select All That Apply)
Ketoacidosis
Pulmonary edema
Atelectasis
Hypoglycemia
Hypokalemia
Correct Answer : B,D,E
Choice A reason: Ketoacidosis is not a typical complication of hyperglycemic hyperosmolar syndrome (HHS) treatment. HHS usually occurs without significant ketoacidosis, and the focus is on managing hyperglycemia and dehydration.
Choice B reason: Pulmonary edema is a potential complication of rapid fluid replacement therapy. The increased fluid volume can overwhelm the heart's ability to pump effectively, leading to fluid accumulation in the lungs.
Choice C reason: Atelectasis is not a common complication of HHS treatment. It is more related to lung collapse or infection rather than fluid or insulin therapy.
Choice D reason: Hypoglycemia is a potential complication of continuous insulin infusion. Close monitoring of blood glucose levels is necessary to prevent blood sugar from dropping too low during treatment.
Choice E reason: Hypokalemia is a potential complication of insulin therapy. Insulin promotes the uptake of potassium into cells, which can reduce serum potassium levels. Monitoring and managing potassium levels is important during HHS treatment.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","E"]
Explanation
Choice A reason: Eating any foods before dialysis as long as fluid intake is limited is incorrect. Patients undergoing hemodialysis need to follow specific dietary restrictions to manage electrolyte balance and prevent complications. A renal diet typically limits potassium, phosphorus, and sodium intake, in addition to fluid restrictions.
Choice B reason: Reporting any unusual changes in the access site, like redness or swelling, is correct. Changes at the access site can indicate infection or other complications and require immediate attention.
Choice C reason: Checking blood pressure regularly to monitor for changes during dialysis is correct. Blood pressure monitoring is essential during dialysis to detect hypotension or hypertension and adjust treatment accordingly.
Choice D reason: Contacting the healthcare provider if swelling in hands, feet, or ankles is noticed is correct. Swelling can indicate fluid overload or other complications that need to be addressed.
Choice E reason: Understanding that hemodialysis will permanently cure kidney disease is incorrect. Hemodialysis is a treatment that replaces kidney function but does not cure kidney disease. It manages symptoms and removes waste products from the blood.
Correct Answer is A
Explanation
Choice A reason: The patient being increasingly drowsy and hard to arouse is an urgent finding that should be reported immediately. This condition may indicate intracranial bleeding or other severe complications related to extremely low platelet count (10,000/mm³) in idiopathic thrombocytopenic purpura (ITP). Immediate medical intervention is required to prevent further deterioration.
Choice B reason: Red, raised purpura on the patient's feet and hands is a concerning finding indicative of significant thrombocytopenia, but it is not as immediately life-threatening as decreased consciousness. It should still be monitored and managed, but the priority is the patient's level of consciousness.
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