Exhibits
The nurse is caring for the client in the ED. The nurse understands that the client is at risk of developing which of the following complications? Select all that apply.

Cerebral edema

Septic shock

Cardiac arrhythmias

Renal failure

Hypotension

Respiratory alkalosis

Answer and Explanation

Correct Answer : A,C,D,E

A. This is a serious complication in DKA, particularly in children, where the shift in osmolality during treatment can lead to fluid shifts into the brain. It can present with neurological deterioration, headache, altered mental status, and even coma.
B.   Septic shock
While infection can precipitate DKA, septic shock itself is not a direct complication of DKA. However, DKA can predispose patients to infections due to impaired immune function, dehydration, and hyperglycemia.
C.   Cardiac arrhythmias
Electrolyte imbalances, particularly hypokalemia or hyperkalemia (depending on treatment phase), can predispose individuals with DKA to cardiac arrhythmias such as ventricular arrhythmias (e.g., ventricular tachycardia) or atrial fibrillation.
D.   Renal failure
Acute kidney injury (AKI) can occur due to dehydration, electrolyte imbalances, and the direct effects of acidosis. However, with prompt and appropriate treatment, renal function typically recovers.
E.   Hypotension
Dehydration and volume depletion are common in DKA due to osmotic diuresis and fluid loss. This can lead to hypovolemic shock and hypotension if not adequately managed with fluid resuscitation.
F Respiratory alkalosis
DKA is associated with metabolic acidosis, not respiratory alkalosis. The body compensates for acidosis by increasing respiratory rate (Kussmaul respirations) to blow off CO2 and normalize pH, but this does not lead to respiratory alkalosis.

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Correct Answer is D

Explanation

D. Paraplegia significantly increases the risk of skin breakdown due to immobility, lack of sensation, and prolonged pressure on specific areas of the body. These clients require meticulous skin care and frequent repositioning to prevent pressure injuries.

A While urinary incontinence can contribute to skin breakdown, especially if not managed properly, it may not pose as great a risk compared to other factors like poor nutrition or immobility.

B. Poor nutrition compromises skin integrity by reducing the skin's ability to repair and maintain itself, making it more susceptible to breakdown. This factor significantly increases the risk of developing pressure ulcers and other skin lesions.

C. Clients with Alzheimer's disease may have increased risk due to various factors such as mobility issues, impaired sensation, and difficulty with self-care. However, the degree of risk can vary depending on the stage of the disease and individual circumstances.

A. Heart rate 60/min B. Blood pressure 90/50 mm Hg C. Oxygen saturation 95% D. Respiratory rate 14/min

Correct Answer is B

Explanation

B. Hypotension suggests inadequate perfusion, which could prompt an increase in dopamine dosage to improve blood pressure and perfusion.

A A heart rate of 60/min is within the normal range for adults and may not necessarily indicate a need to increase dopamine dosage unless accompanied by signs of inadequate perfusion

C. Oxygen saturation of 95% is within the normal range and indicates adequate oxygenation. It does not directly inform the need to increase dopamine dosage

D. A respiratory rate of 14/min is within the normal range. Respiratory rate alone does not typically guide dopamine dosage adjustments unless respiratory distress or acidosis indicates poor tissue perfusion.

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ExhibitsThe nurse is caring for the client in the ED. The nurse understands that the client is at risk of developing which of the following complications? Select all that apply.

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is assessing clients for skin integrity. Which of the following clients is at greatest risk for developing skin breakdown?

Correct Answer is D

Explanation

A nurse in the emergency department is monitoring a client who is receiving dopamine to treat hypovolemic shock. Which of the following findings should the nurse identify as an indication for increasing the client's dopamine dosage?

Correct Answer is B

Explanation

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Exhibits
The nurse is caring for the client in the ED. The nurse understands that the client is at risk of developing which of the following complications? Select all that apply.