A nurse is caring for a client in the emergency department.

The nurse is caring for the client in the ED. The nurse understands that the client is at risk of developing which of the following complications? Select all that apply.

Respiratory alkalosis

Hypotension

Septic shock

Cardiac arrhythmias

Renal failure

Cerebral edema

Answer and Explanation

Correct Answer : B,D,E,F

A. Respiratory alkalosis: The client’s arterial pH is 7.30, indicating acidemia rather than alkalemia. Respiratory alkalosis is not expected in hyperglycemic crises; instead, metabolic acidosis may develop due to ketone accumulation and dehydration.

B. Hypotension: The client’s blood pressure is 96/65 mm Hg, which is lower than normal, likely related to dehydration from osmotic diuresis caused by severe hyperglycemia. Ongoing fluid loss increases the risk of hypotension, making it an important complication to monitor and manage promptly.

C. Septic shock: While the client has a recent history of bronchitis and pneumonia, there is no current evidence of infection such as fever, tachypnea, or elevated WBCs. Although infection could precipitate hyperglycemia, septic shock is not an immediate complication indicated by the current findings.

D. Cardiac arrhythmias: The client has a potassium level of 5.5 mEq/L, which is elevated. Hyperkalemia increases the risk of cardiac arrhythmias, especially in combination with dehydration and acidosis, making close cardiac monitoring necessary.

E. Renal failure: Elevated BUN (21 mg/dL) and creatinine (1.7 mg/dL) suggest impaired renal perfusion or acute kidney injury secondary to dehydration from osmotic diuresis. The client is at risk of progression to renal failure if fluid and electrolyte imbalances are not corrected.

F. Cerebral edema: Cerebral edema is often caused by an overly rapid drop in effective serum osmolarity during treatment, primarily when blood glucose is lowered too quickly. The rapid shift in fluid from the bloodstream to the brain cells can cause swelling.

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Free Nursing Study Resources

Correct Answer is B

Explanation

A. "A possible cause of this problem is a long-term lack of dietary protein.": Age-related macular degeneration is primarily linked to aging, genetics, and oxidative stress, not protein deficiency. Nutrition may play a role in disease progression, but lack of protein is not a causative factor.

B. "You probably have noticed a decline in your central vision.": Central vision loss is the hallmark symptom of age-related macular degeneration, affecting tasks such as reading, driving, and recognizing faces. Peripheral vision is typically preserved, making this statement important for client education.

C. "The doctor can perform surgery to correct this by repairing the folds in your retina.": AMD cannot be corrected by surgery to repair retinal folds. While certain advanced cases may be treated with laser therapy or anti-VEGF injections, surgical repair of folds is not a standard treatment.

D. "You probably have a detachment of your retina.": Retinal detachment is a different ocular condition that involves separation of the retina from the underlying tissue. It is not the cause of vision loss in age-related macular degeneration and does not apply to the disease process.

A. "Wear a high-filtration mask at home when family members are nearby." B. "Before coughing or sneezing, cover your mouth and nose with a tissue. C. "Return to work after two consecutive sputum cultures are negative." D. "Make sure family members wear masks whenever they are in the same room as you."

Correct Answer is B

Explanation

A. "Wear a high-filtration mask at home when family members are nearby.": Clients with TB do not need to wear high-filtration masks at home once effective treatment has begun, as transmission risk decreases rapidly. Home precautions focus more on cough hygiene and ventilation rather than continuous mask use inside the home.

B. "Before coughing or sneezing, cover your mouth and nose with a tissue.": Covering the mouth and nose prevents airborne spread of Mycobacterium tuberculosis by limiting droplet dispersion. This, combined with immediate disposal of tissues and hand hygiene, is essential for protecting household members.

C. "Return to work after two consecutive sputum cultures are negative.": Clearance for work is based primarily on sputum smears, clinical improvement, and provider guidance, not sputum cultures, which take weeks to result. Waiting for negative cultures is unnecessary for determining when a client is no longer infectious.

D. "Make sure family members wear masks whenever they are in the same room as you.": Family members generally do not need to wear masks once the client has started effective treatment for several weeks because infectivity significantly decreases. Emphasis is placed instead on good ventilation, cough etiquette, and adherence to medications.

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A nurse is caring for a client in the emergency department. The nurse is caring for the client in the ED. The nurse understands that the client is at risk of developing which of the following complications? Select all that apply.

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The nurse is caring for the client in the ED. The nurse understands that the client is at risk of developing which of the following complications? Select all that apply.