A client with a history of type 1 diabetes has just been admitted to the critical care unit (CCU) for diabetic ketoacidosis. The CCU nurse should prioritize what assessment during the client's initial phase of treatment?

Monitoring the client for dysrhythmias

Maintaining and monitoring the client's fluid balance

Assessing the client's level of consciousness

Assessing the client for signs and symptoms of venous thromboembolism

Answer and Explanation

The Correct Answer is B

A. Monitoring for dysrhythmias is important, especially due to potential electrolyte shifts, but it is secondary to stabilizing perfusion and hydration.
B. Maintaining and monitoring fluid balance is the top priority in the initial management of diabetic ketoacidosis (DKA) because clients are severely dehydrated due to osmotic diuresis. Prompt fluid resuscitation is essential to restore perfusion and support metabolic correction.
C. Assessing level of consciousness is necessary, especially if cerebral edema is a concern, but it follows after fluid and metabolic stabilization.
D. Venous thromboembolism is a risk in critically ill patients, but it is not an immediate priority in the acute phase of DKA treatment.

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Correct Answer is ["A","C","D"]

Explanation

A. Urine output should be monitored because excess aldosterone leads to sodium and water retention and increased potassium excretion, which can impact fluid balance and renal function.
B. Venous thromboembolism is not a typical complication of aldosteronism and is not a priority in this context.
C. Peripheral pulses help assess circulation, which can be affected by blood pressure changes caused by fluid retention.
D. Blood pressure should be closely monitored, as aldosteronism often leads to hypertension due to sodium and water retention.
E. While skin integrity is important in general assessments, it is not directly related to aldosteronism and is not a priority focus for this condition.

A. Finish all prescribed courses of antibiotics, regardless of symptom resolution. B. Adhere to dosing recommendations of over-the-counter analgesics. C. Ensure that expired medications are disposed of safely. D. Ensure that pharmacists regularly review drug regimens for potential interactions.

Correct Answer is B

Explanation

A. Finishing antibiotics is important to prevent resistance, but not directly related to preventing drug-induced hepatitis.
B. Adhering to dosing recommendations of over-the-counter analgesics, especially acetaminophen, is critical to prevent liver toxicity and drug-induced hepatitis.
C. Proper disposal of expired medications is important but does not prevent drug-induced hepatitis.
D. Pharmacist review helps prevent interactions but is secondary to safe dosing practices in preventing hepatotoxicity.

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A client with a history of type 1 diabetes has just been admitted to the critical care unit (CCU) for diabetic ketoacidosis. The CCU nurse should prioritize what assessment during the client's initial phase of treatment?

Nursing Test Bank

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