A nurse is caring for an adolescent who has been diagnosed with diabetic ketoacidosis (DKA). The nurse notes the following:
When planning care for this client, the nurse should anticipate a provider's prescription for which of the following?
Insulin therapy and fluid replacement
Glucagon injection and potassium supplements
Bicarbonate infusion and sodium restriction
Dextrose infusion and diuretics
The Correct Answer is A
Choice A reason: Insulin therapy and fluid replacement are the main treatments for DKA, as they lower the blood glucose level and correct the dehydration and electrolyte imbalance caused by osmotic diuresis and acidosis.
Choice B reason: Glucagon injection and potassium supplements are not indicated for DKA, as they may worsen the hyperglycemia and the hyperkalemia. Glucagon stimulates the liver to release more glucose into the bloodstream, while potassium supplements may increase the risk of cardiac arrhythmias.
Choice C reason: Bicarbonate infusion and sodium restriction are not the first-line treatments for DKA, as they may have adverse effects on the acid-base balance and the fluid status. Bicarbonate infusion may cause paradoxical cerebral acidosis and hypokalemia, while sodium restriction may exacerbate the hyponatremia and the hypovolemia.
Choice D reason: Dextrose infusion and diuretics are contraindicated for DKA, as they may increase the blood glucose level and the dehydration. Dextrose infusion may trigger a rebound hyperglycemia, while diuretics may cause further fluid and electrolyte loss.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason: Weight loss is not a typical finding in a toddler who has heart failure. Weight gain due to fluid retention is more likely to occur. The nurse should monitor the toddler's weight and fluid intake and output regularly.
Choice B reason: Bradycardia is not a typical finding in a toddler who has heart failure. Tachycardia due to increased cardiac workload is more likely to occur. The nurse should monitor the toddler's heart rate and rhythm frequently.
Choice C reason: Increased urine output is not a typical finding in a toddler who has heart failure. Decreased urine output due to poor renal perfusion is more likely to occur. The nurse should monitor the toddler's urine specific gravity and electrolytes periodically.
Choice D reason: Orthopnea is a typical finding in a toddler who has heart failure. Orthopnea is the difficulty of breathing when lying flat. The nurse should elevate the toddler's head and chest to facilitate breathing and oxygenation.
Correct Answer is D
Explanation
Choice A reason: Holding the infant's chin to his chest and knees to his abdomen during the procedure is not a correct action for the nurse to take. This position may cause spinal cord compression or respiratory distress in the infant. The nurse should position the infant on his side with his back arched and his head and knees flexed.
Choice B reason: Placing the infant in an infant seat for 2 hr following the procedure is not a correct action for the nurse to take. This position may increase the intracranial pressure and cause headaches or vomiting in the infant. The nurse should keep the infant flat or slightly elevated for 4 to 6 hr after the procedure.
Choice C reason: Keeping the infant NPO for 6 hr prior to the procedure is not a correct action for the nurse to take. This may cause dehydration or hypoglycemia in the infant. The nurse should follow the provider's orders for fasting, which are usually 2 to 4 hr for clear liquids and 4 to 6 hr for solids.
Choice D reason: Applying a eutectic mixture of lidocaine and prilocaine cream topically 15 min prior to the procedure is a correct action for the nurse to take. This is a topical anesthetic that can reduce the pain and discomfort of the needle insertion. The nurse should apply the cream to the lower back and cover it with an occlusive dressing.
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