A nurse is admitting a client who has diabetic ketoacidosis. Which of the following types of continuous infusions should the nurse initiate?

0.45% saline

NPH insulin

0.9% normal saline

Glargine insulin

Answer and Explanation

The Correct Answer is C

A. 0.45% saline. This is a hypotonic solution, which may be used later in diabetic ketoacidosis (DKA) management, but it is not appropriate for initial fluid resuscitation as it does not rapidly expand intravascular volume.
B. NPH insulin. NPH is an intermediate-acting insulin and is not used for continuous infusion. In DKA, rapid insulin correction is needed, typically with a short-acting insulin like regular insulin.
C. 0.9% normal saline. This isotonic fluid is the first-line choice for fluid replacement in clients with DKA. It helps restore circulating volume and correct dehydration quickly, which is a critical initial intervention.
D. Glargine insulin. Glargine is a long-acting insulin and not suitable for IV infusion. DKA requires the use of short-acting insulin (e.g., regular insulin) administered via IV infusion to correct hyperglycemia and acidosis.

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Correct Answer is A

Explanation

A. Place the tip of the thermometer under the center of the infant's axilla: This is the correct method for taking an axillary temperature in infants, which is the recommended route due to safety and ease. The tip should be placed snugly in the center of the axilla and the infant's arm should be held firmly against their body to ensure accuracy.
B. Pull the pinna of the infant's ear forward before inserting the probe: This technique is used for otoscopic or tympanic temperature readings in children under 3, but tympanic readings are not preferred in young infants due to the small size and curvature of their ear canals, which can lead to inaccuracy.
C. Insert the oral thermometer in front of the infant's tongue: Oral temperature measurement is inappropriate for infants. They may not be able to keep the thermometer properly positioned, which increases the risk of inaccurate readings or injury.
D. Insert the probe 3.8 cm (1.5 in) into the infant's rectum: Rectal temperature measurement is not routinely recommended unless specifically indicated, and the probe should only be inserted about 1.3 cm (0.5 in) for infants to avoid rectal perforation. The option listed suggests unsafe depth.

A. Hydrocodone B. Acetaminophen C. Fentanyl D. Aspirin

Correct Answer is A

Explanation

A. Hydrocodone. This is an opioid analgesic appropriate for moderate to severe pain, such as a pain rating of 7/10. It is commonly used for acute pain management in cases like fractures and provides effective relief when non-opioids are insufficient.
B. Acetaminophen. While useful for mild to moderate pain, acetaminophen alone is likely inadequate for severe pain like that associated with a fracture rated 7/10.
C. Fentanyl. Fentanyl is a potent opioid used for severe or chronic pain, often in controlled settings such as surgery or cancer care. For an acute fracture, hydrocodone is typically preferred unless pain is extreme or uncontrolled.
D. Aspirin. Aspirin is primarily used for mild pain or anti-inflammatory purposes and is not appropriate as a first-line agent for severe pain. Additionally, it may increase the risk of bleeding, which is a consideration in trauma cases.

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A nurse is admitting a client who has diabetic ketoacidosis. Which of the following types of continuous infusions should the nurse initiate?

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