A patient with diabetic ketoacidosis (DKA) has been receiving insulin for 6 hours. Laboratory finding are Na+ 131, K+ 3.7, CL- 102, HCO3 22, and glucose 170. Which action should the nurse take?
Give potassium intravenously.
Administer D5 NS with the insulin drip.
Administer 3% NS at 200ml/hr
Expect the insulin drip to be discontinued.
The Correct Answer is B
A. Give potassium intravenously. – The potassium level is 3.7 (within normal range 3.5–5.0), so potassium is not needed yet.
B. Administer D5 NS with the insulin drip. – Correct Answer. Once glucose drops to ≤200 mg/dL, dextrose is added to prevent hypoglycemia while continuing insulin to correct ketoacidosis.
C. Administer 3% NS at 200 mL/hr. – Hypertonic saline is used for severe hyponatremia, which is not the case here.
D. Expect the insulin drip to be discontinued. – The insulin drip is not discontinued until ketoacidosis has fully resolved (when HCO3 > 18, pH > 7.3, and anion gap normalizes).
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Related Questions
Correct Answer is B
Explanation
A. Give potassium intravenously. – The potassium level is 3.7 (within normal range 3.5–5.0), so potassium is not needed yet.
B. Administer D5 NS with the insulin drip. – Correct Answer. Once glucose drops to ≤200 mg/dL, dextrose is added to prevent hypoglycemia while continuing insulin to correct ketoacidosis.
C. Administer 3% NS at 200 mL/hr. – Hypertonic saline is used for severe hyponatremia, which is not the case here.
D. Expect the insulin drip to be discontinued. – The insulin drip is not discontinued until ketoacidosis has fully resolved (when HCO3 > 18, pH > 7.3, and anion gap normalizes).
Correct Answer is C
Explanation
A. Leave the television on as a distraction – Noise and distractions can increase anxiety and confusion in some patients.
B. Limit patient physical activity – Regular exercise is essential to maintain mobility and prevent muscle atrophy.
C. Provide patient supervision – Clients with Parkinson’s disease are at high risk for falls due to muscle rigidity and balance difficulties. Supervision ensures safety and helps prevent injuries.
D. Speak loudly to the patient – Parkinson’s does not typically cause hearing loss. Speaking clearly and slowly is more effective than speaking loudly.
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