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 B

Explanation

A. Calories. Significant increases in caloric intake are not necessary during the first trimester. Most women do not require additional calories until the second and third trimesters, when fetal growth accelerates.
B. Folate. Folate (or folic acid) is crucial during early pregnancy, particularly in the first trimester, to prevent neural tube defects such as spina bifida. Women are advised to increase folate intake before conception and during early pregnancy.
C. Calcium. Calcium needs increase later in pregnancy when the fetus's bone development intensifies. While important throughout pregnancy, calcium is not the most critical nutrient to increase specifically in the first trimester.
D. Protein. Protein is essential for fetal growth, but increased protein needs become more important in the second and third trimesters when fetal tissue development peaks. Early pregnancy focuses more on folate supplementation for neural development.

A. Diplopia B. Fever C. Esophagitis D. Bradykinesia

Correct Answer is B

Explanation

A. Diplopia. Double vision (diplopia) is more commonly associated with neurological or ophthalmic disorders such as multiple sclerosis or cranial nerve dysfunction. It is not a typical manifestation of lupus exacerbations.
B. Fever. Fever is a common and expected finding during an acute exacerbation of systemic lupus erythematosus (SLE). It results from systemic inflammation and immune system activation, often indicating disease flare-up or potential infection.
C. Esophagitis. Esophagitis is more often linked to gastroesophageal reflux disease or infections, not systemic lupus. Although lupus can affect many organs, the esophagus is not a typical site of acute involvement in SLE exacerbations.
D. Bradykinesia. Bradykinesia, or slowness of movement, is a hallmark feature of Parkinson’s disease. It is not associated with SLE and would not be expected during a lupus flare.

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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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