A nurse working in an emergency department is reviewing laboratory results of a client who is unconscious and has fruity odor to his breath. The nurse suspects diabetic ketoacidosis. Which of the following results should the nurse expect for this acid-base imbalance?
Bicarbonate 26 mEq/L
Serum pH 7.32
Creatinine 1.2 mg/dL
BUN 20 mg/dL
The Correct Answer is B
A) Bicarbonate 26 mEq/L: A bicarbonate level of 26 mEq/L is within the normal range (22-28 mEq/L) and does not indicate metabolic acidosis, which is characteristic of diabetic ketoacidosis (DKA). In DKA, bicarbonate levels are usually decreased due to buffering of the excess acids.
B) Serum pH 7.32: A serum pH of 7.32 is indicative of acidemia, which is consistent with metabolic acidosis seen in DKA. The pH is typically lower than the normal range (7.35-7.45) in DKA due to the accumulation of ketoacids.
C) Creatinine 1.2 mg/dL: A creatinine level of 1.2 mg/dL is slightly elevated but does not specifically indicate metabolic acidosis. Elevated creatinine may suggest renal impairment but is not directly linked to the acid-base disturbance seen in DKA.
D) BUN 20 mg/dL: A blood urea nitrogen (BUN) level of 20 mg/dL is elevated and may indicate dehydration or kidney dysfunction but does not specifically diagnose the acid-base imbalance associated with DKA. In DKA, bicarbonate and pH levels are more directly affected.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A) Consume a diet low in cholesterol: A diet low in cholesterol is beneficial for preventing cholelithiasis (gallstones), as high cholesterol levels can contribute to the formation of cholesterol stones in the gallbladder. By reducing dietary cholesterol, the risk of gallstone formation can be minimized.
B) Increase your intake of refined carbohydrates: Increasing the intake of refined carbohydrates can lead to higher levels of triglycerides and cholesterol in the blood, which can promote the formation of gallstones. This dietary change is not recommended for preventing cholelithiasis.
C) Consume a diet high in calories: A high-calorie diet, especially if it leads to obesity, increases the risk of developing gallstones. Obesity is a significant risk factor for cholelithiasis, and a high-calorie diet can contribute to weight gain and the development of gallstones.
D) Reduce your dietary fiber intake: Dietary fiber helps in reducing cholesterol levels by binding bile acids in the intestines, which in turn can prevent the formation of cholesterol gallstones. Reducing fiber intake would be counterproductive and increase the risk of cholelithiasis.
Correct Answer is D
Explanation
A) Expect optimum visual acuity to return in 4 to 6 weeks: While some improvement in vision can be noted soon after cataract surgery, optimal visual acuity typically returns within 1 to 2 months. It's important to set realistic expectations for recovery. Telling the patient to expect optimum visual acuity to return in 4 to 6 weeks provides a more accurate timeframe for complete visual recovery.
B) Notify the provider if new floaters persist for more than 3 days: The presence of new floaters can be a sign of complications such as retinal detachment or vitreous hemorrhage. However, patients are generally advised to notify their provider immediately if they notice any new floaters, flashes of light, or a sudden decrease in vision, rather than waiting for three days. Immediate notification can lead to prompt evaluation and treatment if necessary.
C) Take aspirin every 4 to 6 hr for mild discomfort: Aspirin is generally avoided postoperatively due to its blood-thinning properties, which can increase the risk of bleeding. Instead, non-aspirin pain relievers like acetaminophen are usually recommended to manage mild discomfort after cataract surgery, as they do not carry the same risk of bleeding complications.
D) Avoid lifting objects that weigh 9.07 kg (20 lb) or more: Patients are advised to avoid lifting heavy objects and engaging in strenuous activities after cataract surgery to prevent increased intraocular pressure, which can interfere with healing and potentially cause complications such as bleeding or dislocation of the intraocular lens. This instruction helps ensure the safety and proper healing of the surgical site.
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