The nurse requests a meal tray for a client who follows Mormon beliefs and who is on a clear liquid diet following abdominal surgery.
Which menu item(s) should the nurse request for this client? (Select all that apply).

To calculate the amount of darbepoetin alfa that the nurse should administer, you can use the following formula:

Dose (mL) = Amount prescribed (mcg) / Concentration (mcg/mL)

In this case:

Amount prescribed = 40 mcg
Concentration = 60 mcg/mL

Dose (mL) = 40 mcg / 60 mcg/mL = 2/3 mL

Now, you can convert 2/3 mL to decimal to make it easier to work with:

2/3 = 0.6667 mL

Rounded to one decimal place, the nurse should administer approximately 0.7 mL of darbepoetin alfa. So, the correct answer is 0.7 mL.

Choice A rationale:
Starting an insulin drip at 0.1 u/kg/hr is a common treatment for diabetic ketoacidosis (DKA). The goal is to lower blood glucose levels while avoiding a rapid decrease that could lead to cerebral edema. Insulin infusions allow for precise control of the rate and can be adjusted as needed based on the patient’s response.
Choice B rationale:
Giving a long-acting insulin dose is not typically done during the acute treatment of DKA. The patient has already taken a dose of insulin glargine at home. Additional doses of long-acting insulin could potentially lead to hypoglycemia.
Choice C rationale:
Providing an oral medication that enhances insulin production would not be beneficial in this case. The patient has type 1 diabetes, which means her body does not produce insulin. Therefore, medications that stimulate insulin production would not be effective.
Choice D rationale:
Changing the intravenous fluid to 5% dextrose and 0.45% sodium chloride with 20 mEq potassium can help prevent hypoglycemia and hypokalemia, which are potential complications of DKA treatment. As blood glucose levels decrease with treatment, dextrose can help maintain appropriate glucose levels. Potassium is often depleted in DKA and needs to be replaced.
Choice E rationale:
Having the client drink as much as they can tolerate would not be appropriate at this time. The patient is currently experiencing nausea and vomiting, which could be exacerbated by oral fluid intake. Additionally, she is NPO (nothing by mouth), likely due to her unstable condition.
Choice F rationale:
Giving 1 L of 0.9% sodium chloride IV can help correct dehydration, which is common in DKA due to excessive urination caused by high blood glucose levels.
Choice G rationale:
Promoting the removal of electrolytes with a diuretic would not be beneficial in this case. The patient is likely already dehydrated and may have electrolyte imbalances due to DKA. Using a diuretic could exacerbate these issues.
Choice H rationale:
Giving a multivitamin is not typically part of the acute treatment for DKA. While overall nutritional status is important in managing diabetes, it would not address the immediate concerns of hyperglycemia and acidosis in DKA.
Choice I rationale:
Replacing potassium as needed is crucial in the treatment of DKA. Potassium levels can drop rapidly during treatment as insulin allows potassium to move back into cells. Low potassium (hypokalemia) can cause dangerous heart rhythms and muscle weakness.