A nurse is caring for a client who is experiencing diabetic ketoacidosis (DKA). Which of the following is the priority intervention by the nurse?

Check potassium levels.

Administer 0.9% sodium chloride.

Begin bicarbonate continuous IV infusion.

Initiate a continuous IV insulin infusion.

Answer and Explanation

The Correct Answer is B

A. Checking potassium levels is important in the management of DKA, but it is not the priority intervention. Potassium levels should be monitored closely, as insulin therapy can lower potassium levels, but the first step in treatment is fluid resuscitation.

B. Administering 0.9% sodium chloride (normal saline) is the priority intervention in DKA. This helps to correct dehydration and restore circulatory volume, which is critical in stabilizing the client. Fluid replacement is the first step in managing DKA before insulin is administered.

C. Beginning bicarbonate continuous IV infusion is typically not recommended unless the pH is extremely low (below 6.9). The primary treatment in DKA is fluid and insulin therapy, and bicarbonate is used only in severe cases of acidosis.

D. Initiating a continuous IV insulin infusion is essential in treating DKA, but it should be done after initial fluid resuscitation. Insulin therapy lowers blood glucose and helps to resolve ketosis, but fluid replacement is the first priority to stabilize the client.

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Correct Answer is B

Explanation

A. Keep the client's bedroom dark at night is not recommended. People with Alzheimer's disease may experience confusion and disorientation, especially during the night. Keeping the room well-lit can help reduce confusion and improve the client's sense of time.

B. Place a large-face clock in the client's bedroom is a helpful strategy. A large clock can help the client orient themselves to the time of day, which can reduce anxiety and confusion. This is an effective way to help clients with Alzheimer's disease maintain a sense of time and structure.

C. Cover electrical outlets in the client's home with tape is not a necessary safety measure for Alzheimer's disease. While safety is important, the primary focus should be on reducing the risk of falls, confusion, and disorientation. Tape on outlets is not a standard safety recommendation for Alzheimer's patients.

D. Hang a monthly calendar in the client's bedroom is a good idea for some clients, but a calendar may not be as immediately helpful as a clock in the bedroom. While a calendar can help orient the client to the date, a clock is more effective for helping them understand the time of day.

A. "I apply a lubricating lotion to the cracked areas on the soles of my feet every morning." B. "I rest in my recliner with my feet elevated for about an hour every afternoon." C. "I soak my feet in hot water before trimming my toenails." D. "I use my heating pad on a low setting to keep my feet warm."

Correct Answer is A

Explanation

A. Applying a lubricating lotion to cracked areas is appropriate for clients with peripheral arterial disease (PAD). This helps to prevent further skin breakdown and maintain skin integrity, which is crucial since clients with PAD have poor circulation and are at risk for ulcers and infections.

B. Resting with feet elevated is not recommended for clients with PAD. Elevating the feet can further reduce blood flow to the lower extremities. Instead, the client should avoid elevating the legs and should consider positioning the feet at heart level or in a dependent position to promote circulation.

C. Soaking feet in hot water is not recommended for clients with PAD because they may have reduced sensation and are at risk for burns. Additionally, hot water can exacerbate circulation problems and increase the risk of injury.

D. Using a heating pad is not recommended for clients with PAD because they may have impaired sensation in their feet. The heating pad could cause burns or other injuries due to the lack of feeling in the affected areas.

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A nurse is caring for a client who is experiencing diabetic ketoacidosis (DKA). Which of the following is the priority intervention by the nurse?

Nursing Test Bank

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