A 79-year-old patient is receiving a quinolone for treatment of a complicated incision infection.
For which adverse effect associated with these drugs should the nurse monitor?

The correct answer is Choice D.

Let’s go through the calculations step by step:

Step 1: Convert all the quantities to milliliters (mL), as the nurse needs to record the intake in mL. We know that 1 oz is approximately 29.5735 mL.

4 oz of juice = 4 × 29.5735 mL = 118.294 mL

6 oz of tea = 6 × 29.5735 mL = 177.861 mL 8 oz of broth = 8 × 29.5735 mL = 236.628 mL Step 2: Add all the quantities together:

118.294 mL (juice) + 177.861 mL (tea) + 100 mL (soda) + 150 mL (IV bolus) + 236.628 mL (broth) = 783.783 mL Step 3: Round off the total intake to the nearest whole number as required, which gives us 784 mL.

Therefore, the nurse should record 784 mL on the patient’s chart. However, this option is not available in the choices given. The closest option to this calculated value is 800 mL (Choice D).

Now, let’s discuss the rationales for each choice:

Choice A rationale:

500 mL would be an underestimate of the patient’s fluid intake. It does not account for all the fluids the patient consumed.

Choice B rationale:

600 mL, similar to Choice A, is an underestimate. It does not accurately represent the total volume of fluids the patient consumed. Choice C rationale:

700 mL is closer to the calculated intake but is still an underestimate. It does not fully account for all the fluids the patient consumed.

Choice D rationale:

800 mL is the closest option to the calculated intake of 784 mL. Although it’s slightly over the actual intake, it’s the best choice among the given options.

Choice A rationale:

Confusion can be a symptom of Diabetic Ketoacidosis (DKA). DKA is a serious complication of diabetes that occurs when your body produces high levels of blood acids called ketones. The condition develops when your body can’t produce enough insulin. Insulin normally plays a key role in helping sugar (glucose) — a major source of energy for your muscles and other tissues — enter your cells. Without enough insulin, your body begins to break down fat as fuel. This process produces a buildup of acids in the bloodstream called ketones, eventually leading to diabetic ketoacidosis if untreated.

Choice B rationale:

Polydipsia, or excessive thirst, is another common symptom of DKA. High blood sugar levels can cause increased urination, leading to dehydration and an increased feeling of thirst.

Choice C rationale:

A rapid pulse is also a symptom of DKA. This is because the body is trying to compensate for the low amount of fluid in your blood vessels due to dehydration.

Choice D rationale:

Clammy skin is not typically a symptom of DKA. It’s more commonly associated with hypoglycemia (low blood sugar), not hyperglycemia (high blood sugar) which is what occurs in DKA1.