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. Administer antibiotics when available. – Correct Answer. Bacterial meningitis is a medical emergency. The priority is to start IV antibiotics as soon as possible to prevent complications such as sepsis, increased ICP, and neurological damage.

B. Reduce environmental stimuli. – Incorrect. While reducing stimuli helps with photophobia and headache, it is not the priority over immediate antibiotic therapy.

C. Document intake and output. – Incorrect. Monitoring fluid balance is important, but it does not directly treat the infection.

D. Maintain seizure precautions. – Incorrect. Seizure precautions are necessary, but rapid antibiotic administration takes precedence.

A. suggest the visitors stay a bit longer to provide support and distraction. B. suggest the patient ambulates in the hallway to become fatigued, so they can rest. C. turn the lights and television off except for a night light. D. turn on the television to be used as a distractor for the patient.

Correct Answer is C

Explanation

A. Suggest the visitors stay a bit longer to provide support and distraction. – Noise and stimulation can worsen migraines.

B. Suggest the patient ambulates in the hallway to become fatigued, so they can rest. – Movement may increase pain.

C. Turn the lights and television off except for a night light. – Correct Answer. Migraines are worsened by light and noise, so a dark and quiet environment is best.

D. Turn on the television to be used as a distractor for the patient. – Bright lights and sound can aggravate symptoms.

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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?

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