The nurse is caring for a patient with obesity who is being considered for bariatric surgery. Which do the criteria guidelines for bariatric surgery include?

A. Obtain a prescription for supplemental oxygen: This is the correct answer. The patient is experiencing hypoxia, and ensuring adequate oxygenation is the priority. Oxygen supplementation is essential to correct the hypoxia, which can exacerbate metabolic disturbances like diabetic ketoacidosis (DKA). Improving oxygenation will also support other treatments, such as insulin administration, by improving tissue perfusion.
B. Obtain a prescription to administer insulin: While insulin is a key treatment for DKA, addressing hypoxia first is more urgent. Hypoxia can impair the effectiveness of insulin and other therapies, so stabilizing the patient’s oxygen levels should be prioritized before insulin administration.
C. Obtain a prescription to administer intravenous fluids: Administering fluids is important in DKA management, especially for rehydration and correcting electrolyte imbalances. However, addressing hypoxia first is the priority to stabilize the patient and ensure optimal perfusion for further interventions like fluid resuscitation.
D. Obtain a prescription to check the client's glucose level: This is not necessary, as the glucose level is likely already elevated, which is characteristic of DKA. The focus should be on stabilizing the patient's airway and oxygenation before monitoring glucose levels or starting insulin.

A. Shake the MDI prior to administration: This is the correct action. Shaking the MDI ensures that the medication is evenly mixed with the propellant, which is essential for delivering the correct dose. If the inhaler is not shaken, the medication may not be properly dispensed.
B. Ask the client to inhale the medication quickly for 1 second: This is incorrect. The client should inhale slowly and deeply to ensure the medication reaches the lower airways. A quick inhalation may not allow the medication to be delivered effectively, reducing its therapeutic effect.
C. Wash the MDI canister in warm water after each use: This is incorrect. The MDI canister itself should not be washed as it may damage the device. Only the mouthpiece should be cleaned according to the manufacturer's instructions. Overwashing the device can cause malfunctions.
D. Ask the client to hold their breath for 2 seconds after inhalation: This is too short. The client should hold their breath for about 10 seconds to allow the medication to fully reach the lungs and be absorbed. A brief hold, such as 2 seconds, may not be enough to maximize the medication's effectiveness.