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.

Answer and Explanation

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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Correct Answer is A

Explanation

A. Loosen the patient's restrictive clothing – This helps prevent airway obstruction and allows for better chest expansion during the seizure.

B. Open the patient’s jaws to insert an oral airway – Never attempt to force open the mouth during a seizure, as it can cause injury.

C. Restrain the patient to prevent injury – Restraining can cause further harm and should be avoided. Instead, clear the area around the patient to prevent injury.

D. Place patient in high-Fowler’s position – The patient should be placed in a side-lying position to prevent aspiration, not high-Fowler’s.

A. Keep a padded tongue blade available at the patient's bedside. B. Place the patient's bed in the high position. C. Keep the lights on when the patient is sleeping. D. Obtain IV access.

Correct Answer is D

Explanation

A. Incorrect. Never insert anything into a seizing patient's mouth, as it can cause injury.

B. Incorrect. The bed should be in the lowest position to prevent falls.

C. Incorrect. Keeping lights on is unnecessary and can cause sensory overstimulation.

D. Correct. IV access is important in case emergency medications (e.g., lorazepam) are needed during a seizure.

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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?

Nursing Test Bank

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