Cardiac monitoring is initiated for a patient with diabetic ketoacidosis. The nurse determines that this measure is important to identify:

Electrocardiographic (ECG) changes and dysrhythmias related to hypokalemia.

The presence of hypovolemic shock related to osmotic diuresis.

Cardiovascular collapse resulting from the eﬀects of hyperglycemia.

Fluid overload resulting from aggressive ﬂuid replacement.

Answer and Explanation

The Correct Answer is A

Electrocardiographic (ECG) changes and dysrhythmias related to hypokalemia are the main reasons for initiating cardiac monitoring in patients with diabetic ketoacidosis. In diabetic ketoacidosis, insulin deficiency causes the body to break down fat for energy, leading to the production of ketones and resulting in metabolic acidosis. In addition, glucose and potassium are lost in the urine due to osmotic diuresis. Hypokalemia can cause ECG changes and dysrhythmias, which can be life-threatening.

Hypokalemia is a common complication of DKA and can lead to ECG changes such as ST-segment depression, T-wave inversion, and U waves².

Hypovolemic shock related to osmotic diuresis is an important consideration in the management of diabetic ketoacidosis, but it is not the primary reason for initiating cardiac monitoring.

Cardiovascular collapse resulting from the eﬀects of hyperglycemia is not a common complication of diabetic ketoacidosis, and it is not the primary reason for initiating cardiac monitoring.

Fluid overload resulting from aggressive ﬂuid replacement is a potential complication of diabetic ketoacidosis, but it is not the primary reason for initiating cardiac monitoring.

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Correct Answer is B

Explanation

Furosemide is a loop diuretic that works by blocking the reabsorption of sodium and chloride in the ascending loop of Henle in the kidney, leading to increased urine output. However, this medication can also cause potassium loss through increased urinary excretion, which can lead to hypokalemia (low potassium level). Hypokalemia can cause confusion, weakness, and other neurological symptoms.

The normal range for serum potassium is 3.5 to 5.0 mEq/L. A potassium level of 2.9 mEq/L is below the normal range and is considered hypokalemic. Therefore, the nurse should correlate the client's confusion with the low potassium level and notify the healthcare provider to adjust the medication or provide potassium supplements if indicated.

A. increase the eﬀectiveness of the drug by taking it with cranberry juice to acidify the urine. B. take two of the pills a day for 5 days and reserve the rest of the pills to take it the symptoms reappear. C. take the antibiotic for the full 7 days, even if symptoms improve in a few days. D. return to the clinic in 3 days so that a urine culture can be done to evaluate the eﬀectiveness of the drug.

Correct Answer is C

Explanation

The nurse's instruction to the patient is to take the antibiotic for the full 7 days, even if symptoms improve in a few days. This is because the full course of antibiotics is needed to eliminate the bacteria causing the UTI, even if the patient starts to feel better before the end of the treatment course. Failure to complete the full course of antibiotics can lead to the development of antibiotic resistance and the recurrence of the infection. The other options are not appropriate or eﬀective measures for managing a UTI with antibiotics.

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Cardiac monitoring is initiated for a patient with diabetic ketoacidosis. The nurse determines that this measure is important to identify:

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Naxlex Comprehensive Predictor Exams

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Explanation

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Explanation

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