A patient is admitted to the hospital with hyperosmolar hyperglycemia. The patient has a BG value of 987 mg/dL. Which is the priority focus while providing care?
Identifying age-related changes
Monitoring BG level
Establishing the presence of an illness
Improving hydration status
The Correct Answer is D
D. The priority focus in the acute management of hyperosmolar hyperglycemia is improving hydration status. Patients with HHS are severely dehydrated due to the osmotic diuresis caused by extremely high blood glucose levels. Rapid rehydration is critical to prevent shock, improve organ perfusion, and reduce blood glucose levels.
A. It's important to consider age-related changes in any patient but this is not the immediate priority in the acute management of hyperosmolar hyperglycemia. The primary concern is addressing the acute, life-threatening aspects of the condition.
B. Monitoring blood glucose levels is critical in managing hyperosmolar hyperglycemia. However, while it is essential to track the BG levels to guide insulin therapy and assess the response to treatment, it is not the immediate priority in terms of interventions needed to stabilize the patient initially.
C. Determining the underlying cause of hyperosmolar hyperglycemia, such as an infection or other illness, is important for comprehensive treatment. However, it is a secondary priority to stabilizing the patient’s current acute condition.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
B. Morning is considered the ideal time for collecting a sputum specimen. Overnight, mucus accumulates in the respiratory tract because the patient is less active and not clearing their throat or coughing as much. This means that the mucus is more concentrated and has had time to build up, providing a more substantial and representative sample of what is in the lungs.
A. Collecting a sputum specimen at bedtime is generally not ideal. By the end of the day, the patient’s respiratory tract might have cleared some of the accumulated mucus naturally through coughing or other activities.
C. Collecting a sputum specimen after meals is not recommended. Eating can introduce food particles and bacteria from the mouth into the sputum, contaminating the sample.
D. Starting antibiotics before collecting a sputum specimen can alter the bacterial flora present in the respiratory tract. This can lead to a false-negative result or an inaccurate representation of the pathogens causing the infection.
Correct Answer is C
Explanation
C. The spacer helps to deliver more medication to the lungs by holding the medication in the chamber, allowing the patient to inhale it more slowly and deeply. This results in better deposition of the medication in the lower airways and reduces the amount of medication that is deposited in the mouth and throat.
A. The primary purpose of the spacer is to increase the amount of medication that reaches the lungs and to reduce the amount deposited in the oropharynx (throat). The spacer helps to ensure that more medication is delivered directly to the airways where it is needed, thereby enhancing the effectiveness of the treatment and reducing side effects.
B. The exhalation slots or vents on a spacer are designed to allow the patient to exhale easily without removing the device from the mouth. The lips should form a tight seal around the mouthpiece of the spacer to ensure effective inhalation, but the exhalation slots should not be intentionally covered.
D. When using a spacer with an MDI, the patient should inhale slowly and deeply. Rapid inhalation can cause the medication to be deposited in the upper airways rather than reaching the lungs. A slow and deep inhalation allows for better medication delivery to the lower airways.
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