A client with Type 2 diabetes is brought into the emergency room in an unresponsive state. A diagnosis of hyperglycemic hyperosmolar nonketotic coma (HHNK) is made. The nurse prepares for the administration of which initial therapy?

Administration of glucagon

Large amounts of IV saline solution

Long-acting IV insulin

Oxygen by nasal cannula

Answer and Explanation

The Correct Answer is B

B. Large amounts of IV saline solution: This is the correct initial therapy. HHNK is characterized by severe dehydration due to osmotic diuresis resulting from hyperglycemia. Therefore, the administration of large amounts of IV saline solution is essential to correct dehydration, restore intravascular volume, and improve tissue perfusion.
A. Glucagon is typically administered to treat severe hypoglycemia, not hyperglycemia.
C. Short-acting or regular insulin is administered initially to lower blood glucose levels rapidly. Long-acting insulin formulations may be used later to maintain glycemic control once the acute phase is managed.
D. Oxygen therapy may be indicated if the client is hypoxic, but it is not the initial therapy for HHNK. The priority in HHNK is to correct dehydration and hyperglycemia through fluid resuscitation and insulin therapy, respectively.

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Correct Answer is A

Explanation

A. Cleans and dries the perianal area after each diarrheal stool: This is the correct option. Effective perianal care for a client with diarrhea, such as ulcerative colitis, involves gentle cleansing and thorough drying of the perianal area after each stool. Proper hygiene helps prevent skin breakdown and irritation caused by prolonged contact with stool.
B. Alcohol can be irritating to the skin and may exacerbate perianal irritation and discomfort. Therefore, using alcohol compresses is not considered an appropriate perianal care practice.
C. While antidiarrheal medications may be prescribed for clients with ulcerative colitis to help manage symptoms, asking for medication after each stool is not a typical or recommended approach. The frequency and timing of antidiarrheal medication administration should be based on healthcare provider recommendations and individual symptom management plans.
D. While Sitz baths can provide relief from perianal discomfort and promote healing, taking an hour-long Sitz bath after each stool may be impractical and excessive. Sitz baths are typically recommended for shorter durations (e.g., 10-20 minutes) and may be used periodically rather than after every stool.

A. Change the IV site dressing every 48-72 hours B. Change the IV tubing every 24 hours C. Weigh the client every other day on the same scale D. Obtain the client's blood glucose every 12 hours

Correct Answer is B

Explanation

B. Changing the IV tubing every 24 hours helps prevent the accumulation of bacteria and other contaminants within the tubing, reducing the risk of infection. This practice is particularly important for clients receiving TPN, as they are at higher risk of infection due to the direct infusion of nutrients into the bloodstream.
A. It is essential to maintain the integrity of the IV site to prevent infection and ensure proper TPN delivery. Changing the IV site dressing every 24 hours helps minimize the risk of contamination and infection at the insertion site.
C. Regular monitoring of the client's weight is not necessary.
D. While monitoring blood glucose levels is important for clients at risk of hyperglycemia or hypoglycemia, the frequency of monitoring should be individualized based on the client's clinical condition and risk factors.

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A client with Type 2 diabetes is brought into the emergency room in an unresponsive state. A diagnosis of hyperglycemic hyperosmolar nonketotic coma (HHNK) is made. The nurse prepares for the administration of which initial therapy?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse identifies a client problem of impaired skin integrity related to diarrhea for a client who has ulcerative colitis. The nurse recognizes that teaching about perianal care has been effective when the client:

Correct Answer is A

Explanation

The nurse is assessing a client who is receiving total parenteral nutrition (TPN) therapy via an Infusion pump. Which action would be appropriate?

Correct Answer is B

Explanation

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