What is the term for an excess of urea and other nitrogenous wastes in the blood as a result of kidney insufficiency?

Choice A reason: This hypotonic saline solution is often used after initial resuscitation, especially when the patient’s serum sodium is normal or elevated. It helps replace intracellular fluid losses and provides ongoing hydration without excessively increasing sodium levels. It is typically administered once the initial intravascular volume is restored with isotonic fluids.

Choice B reason: This isotonic saline solution is the first-line intravenous fluid used in DKA. It helps expand intravascular volume quickly, restore tissue perfusion, and correct hypovolemia caused by osmotic diuresis. It is given initially as a bolus, followed by continuous infusion until the patient is stabilized.

Choice C reason: This dextrose-containing solution is introduced once blood glucose falls to approximately 200–250 mg/dL. At this point, insulin therapy must continue to clear ketones and correct acidosis, but dextrose is added to prevent hypoglycemia. It is usually combined with saline (e.g., D5 0.45% NS) to balance hydration and glucose support.

Choice D reason: This balanced electrolyte solution is not typically the preferred fluid in DKA management because the lactate component may complicate interpretation of acid–base status. Although it can expand volume, it is generally avoided in favor of saline solutions that more directly address dehydration and electrolyte imbalance in DKA.

Choice E reason: This form of insulin is the only type used intravenously in DKA. A continuous infusion of regular insulin is essential to reduce blood glucose, suppress ketone production, and correct metabolic acidosis. It is carefully titrated with close monitoring of electrolytes, especially potassium, since insulin drives potassium into cells and can cause hypokalemia.

Performing hand hygiene before and after handling the dialysis equipment is essential to prevent infection in peritoneal dialysis.

Hand washing and appropriate use of a mask can help avoid peritonitis, which is a serious complication of peritoneal dialysis.

Choice A is wrong because administering antibiotics prophylactically is not recommended for peritoneal dialysis patients, as it can increase the risk of antibiotic resistance and adverse effects.

Choice C is wrong because allowing the client to handle the dialysis equipment independently may increase the risk of contamination and infection.

The client should be supervised and instructed by a nurse on how to use sterile technique when connecting and disconnecting the transfer set.

Choice D is wrong because discontinuing the peritoneal dialysis if the client develops a fever may worsen the client’s condition and lead to fluid overload and electrolyte imbalance.

The client should be evaluated for signs of infection and treated accordingly.