A nurse in the emergency department is admitting a client who has diabetic ketoacidosis and a blood glucose level of 800 mg/dL. Which of the following interventions should the nurse initiate first?
Potassium chloride 10 mEq/hr
Bicarbonate by IV infusion
Subcutaneous insulin injections
0.9% sodium chloride 15 mL/kg/hr
The Correct Answer is D
Choice A rationale: While potassium replacement is important in diabetic ketoacidosis, fluid resuscitation to restore intravascular volume, improve renal perfusion, and flush out ketones.
Choice B rationale: Bicarbonate infusion might be considered in severe acidosis, but fluid administration is the priority.
Choice C rationale: The priority intervention for a client with diabetic ketoacidosis and very high blood glucose levels is to initiate fluid resuscitation to restore intravascular volume, improve renal perfusion, and flush out ketones.
Choice D rationale: The first intervention the nurse should initiate is fluid resuscitation with 0.9% sodium chloride at a rate of 15 mL/kg/hr to restore intravascular volume, improve renal perfusion, and flush out ketones.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale: While monitoring kidney function might be necessary for some medications, it's not a routine monitoring requirement for tuberculosis medication.
Choice B rationale: Treatment for active pulmonary tuberculosis typically involves combination therapy with multiple medications to effectively target the bacteria and prevent resistance.
Choice C rationale: The duration of tuberculosis treatment varies but typically ranges from 6 to 9 months, not 3 years.
Choice D rationale: Tuberculin skin tests are used for diagnosis and not typically for monitoring treatment progress.
Correct Answer is C
Explanation
Choice A rationale: While monitoring sodium levels is important, a level of 139 mEq/L is within the normal range and might not directly correlate with cyclosporine
administration.
Choice B rationale: Though BUN levels can indicate kidney function, a level of 18 mg/dL falls within the normal range and might not immediately indicate adverse effects related to cyclosporine.
Choice C rationale: Cyclosporine, often prescribed for rheumatoid arthritis, can impact kidney function. An elevated creatinine level (2.5 mg/dL) might signify potential kidney impairment, necessitating immediate attention from the provider to assess and manage any adverse effects of the medication on renal function.
Choice D rationale: A potassium level of 4.2 mEq/L is within normal limits and might not directly relate to potential complications due to cyclosporine therapy.
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