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.
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
The correct answer is c. I will eat foods high in potassium because the diuretics cause potassium loss.
Rationale for Choice A:
- Statement:"I should weigh myself daily and report any sudden weight loss or gain."
- Rationale:This statement is correct.It's crucial for patients with SIADH to monitor their weight daily as even slight fluctuations can signal fluid imbalances.Sudden weight gain can indicate fluid retention,while sudden weight loss might suggest dehydration.Both scenarios warrant medical attention.
Rationale for Choice B:
- Statement:"I need to limit my fluid intake to no more than 1 quart of liquids a day."
- Rationale:This statement is also correct.Fluid restriction is a cornerstone of SIADH management.By limiting fluid intake,patients can help prevent the buildup of excess fluid in the body,which can lead to complications such as hyponatremia (low sodium levels in the blood) and edema.
Rationale for Choice C:
- Statement:"I will eat foods high in potassium because the diuretics cause potassium loss."
- Rationale:This statement is incorrect.While some diuretics used in the treatment of SIADH can indeed cause potassium loss,this is not a universal side effect.Furthermore,increasing potassium intake without medical supervision can be dangerous,potentially leading to hyperkalemia (high potassium levels in the blood).It's essential for patients to consult with their healthcare providers for individualized guidance on potassium intake.
Rationale for Choice D:
- Statement:"I need to shop for foods that are low in sodium and avoid adding salt to foods."
- Rationale:This statement is correct.A low-sodium diet is often recommended for patients with SIADH to help manage fluid balance and prevent hyponatremia.Restricting sodium intake can reduce fluid retention and help maintain appropriate sodium levels in the blood.
Correct Answer is A
Explanation
The first step in the education plan should be to assess their understanding and perception of the disease. This will help the nurse to identify any misconceptions or knowledge gaps that the patient may have and tailor the education plan accordingly. Understanding the patient's perceptions will also help the nurse to establish a trusting relationship with the patient and increase their engagement in diabetes self-management.
Options b, c, and d are important components of the diabetes education plan, but they should be implemented after the initial assessment of the patient's perception and understanding of their diagnosis.
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