A client with diabetes presents with suspected DK
Hypovolemia.
Hyperglycemia.
Dehydration.
Prolonged capillary refill time.
The Correct Answer is C
Dehydration.
Choice A rationale:
Hypovolemia Hypovolemia refers to a decreased blood volume and can lead to decreased urine output.
However, in the context of a patient with suspected DKA, the primary concern is dehydration due to excessive loss of fluids and electrolytes through polyuria (excessive urination) and osmotic diuresis.
This leads to dehydration rather than hypovolemia.
Choice B rationale:
Hyperglycemia Hyperglycemia is a characteristic feature of DKA, but it doesn't directly cause decreased urine output.
In fact, hyperglycemia often leads to increased urine output due to the osmotic diuresis caused by high blood glucose levels.
Choice D rationale:
Prolonged capillary refill time Prolonged capillary refill time is a sign of poor perfusion and can be associated with hypovolemia.
However, it is not the primary concern in a patient with suspected DKA who is experiencing dehydration.
The decreased urine output is primarily due to the loss of fluids and electrolytes from hyperglycemia and osmotic diuresis.
Now, let's move on to the next question.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale:
Insulin is a crucial part of managing diabetes, especially in the case of diabetic ketoacidosis (DKA).
It helps lower blood sugar levels and counteracts the effects of high blood glucose, which is characteristic of DKA.
Avoiding insulin at all costs is not an appropriate approach as it can lead to worsening of DKA.
Choice B rationale:
The nurse should emphasize the need for frequent monitoring of blood glucose levels.
This is because DKA is associated with significantly elevated blood glucose levels.
Regular monitoring allows for timely adjustments in insulin and other treatments, reducing the risk of complications.
Monitoring blood glucose levels is a fundamental aspect of diabetes management.
Choice C rationale:
Consuming a high-carbohydrate diet is not advisable in the context of DKA prevention.
High-carbohydrate diets can lead to elevated blood sugar levels, which may exacerbate the risk of DKA.
It's essential to maintain a balanced and controlled carbohydrate intake for individuals with diabetes.
Choice D rationale:
Avoiding follow-up appointments is not a suitable approach for DKA prevention.
Regular follow-up appointments with healthcare providers are essential for monitoring and adjusting the diabetes management plan.
Skipping follow-up appointments can lead to uncontrolled blood sugar levels and an increased risk of DKA.
Correct Answer is A
Explanation
Choice A rationale:
Education on insulin therapy is a fundamental aspect of DKA management.
Insulin is a crucial component in treating DKA as it helps lower elevated blood glucose levels and corrects the ketosis and acidosis.
It is essential for the patient and their family to understand how insulin works, how to administer it, and when to administer it.
Proper insulin therapy can prevent further complications and guide the management of DKA.
Choice B rationale:
Focusing solely on dietary recommendations is not appropriate in the initial management of DKA.
While dietary management is important for long-term diabetes care, it is not the primary focus during the acute phase of DKA.
The priority is to address the high blood glucose levels and ketoacidosis, which is best achieved through insulin therapy and fluid resuscitation.
Choice C rationale:
Avoiding discussions about blood glucose monitoring is not recommended.
Blood glucose monitoring is a critical aspect of DKA management.
It helps healthcare providers determine the effectiveness of insulin therapy and the patient's response to treatment.
Avoiding these discussions would be detrimental to the patient's care.
Choice D rationale:
Neglecting to mention the risk of cerebral edema is not appropriate in DKA education.
Cerebral edema is a severe complication of DKA that can be life-threatening.
It is crucial to inform the patient and their family about this risk so they can seek prompt medical attention if symptoms occur.
Neglecting to mention this risk could lead to delayed treatment and potential harm to the patient.
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