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Patient Data.

Exhibits

What are the signs and symptoms of DKA? Select all that apply.

Hyperglycemia.

Ketonuria.

Metabolic acidosis.

Hypokalemia.

Dehydration.

Kussmaul respirations

Answer and Explanation

Correct Answer : A,B,C,E,F

Choice A rationale:

Hyperglycemia is a key symptom of DKA. It occurs when there is an insufficient amount of insulin in the body to allow glucose to enter cells for use as energy. As a result, the body begins to break down fat for fuel, leading to the production of ketones and causing blood glucose levels to rise1. Normal blood glucose levels are between 4.0 to 6.0 mmol/L when fasting and up to 7.8 mmol/L two hours after eating2.

Choice B rationale:

Ketonuria, or the presence of ketones in the urine, is another symptom of DKA. When the body breaks down fat for energy, ketones are produced. If too many ketones build up in the blood, they can spill over into the urine1.

Choice C rationale:

Metabolic acidosis occurs in DKA due to the accumulation of ketones in the blood. Ketones are acidic, and when they build up in the blood, they cause the blood to become more acidic, leading to metabolic acidosis1.

Choice D rationale:

Hypokalemia is not a symptom of DKA. In fact, patients with DKA often have high potassium levels in their blood at presentation because acidosis causes potassium to move from inside the cells into the bloodstream1. However, during treatment for DKA, when insulin is administered and acidosis is corrected, potassium moves back into the cells and can lead to low potassium levels or hypokalemia1.

Choice E rationale:

Dehydration is a common symptom of DKA. High blood glucose levels lead to increased urination as the body tries to get rid of the excess glucose. This can result in dehydration1.

Choice F rationale:

Kussmaul respirations are a type of hyperventilation that occurs in DKA as the body tries to get rid of excess acids (ketones) through the lungs by breathing rapidly and deeply1.

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Correct Answer is A

Explanation

Choice A rationale:

The nurse should instruct the client to sleep with an extra pillow under their head. This position, known as the semi-Fowler's position, elevates the upper body and head, which can help reduce shortness of breath and difficulty breathing while lying down at night. Propranolol, a non-selective beta-blocker, can cause bronchoconstriction in some individuals, especially those with a history of respiratory issues. Elevating the head can assist in improving lung expansion and reducing the sensation of breathlessness.

Choice B rationale:

Sleeping on their left side would not be the best option in this case. While sleeping on the left side is often recommended for individuals with certain cardiac conditions to improve blood flow and reduce pressure on the heart, it may not be as effective for alleviating the respiratory symptoms caused by propranolol. Elevating the head is a more appropriate intervention in this scenario.

Choice C rationale:

Sleeping on their right side is not the ideal choice either. While it can have benefits for individuals with certain cardiac conditions, it does not address the specific respiratory symptoms reported by the client. Elevating the head is a more targeted intervention to alleviate breathlessness associated with propranolol.

Choice D rationale:

Sleeping on their back may worsen the client's symptoms. Lying flat on the back can lead to increased pressure on the diaphragm, making it more challenging to breathe for individuals experiencing shortness of breath. Therefore, it is not the recommended position for this client.

A. Encourage the client to continue with the scheduled surgery. B. Document that the client has expressed concerns about the surgery. C. Notify the charge nurse of the client's concerns about surgery. D. Remind the client that the consent has already been obtained.

Correct Answer is C

Explanation

When a preoperative client expresses fear and uncertainty about undergoing surgery, the priority action for the practical nurse (PN) is to notify the charge nurse of the client's concerns. This is important because the charge nurse can coordinate appropriate interventions and support for the client, ensuring their emotional well-being and addressing their fears.

Let's evaluate the other options:

a) Encourage the client to continue with the scheduled surgery.
While it is important to provide support and reassurance to the client, simply encouraging them to continue with the scheduled surgery may not adequately address their specific concerns and fears. The charge nurse and the healthcare team should be involved to provide the necessary support and information to help alleviate the client's anxiety.

b) Document that the client has expressed concerns about the surgery.
Documenting the client's concerns is important for accurate record-keeping and continuity of care. However, it should not be the only action taken. Notifying the charge nurse is crucial to ensure appropriate follow-up and support for the client.

d) Remind the client that the consent has already been obtained.
Reminding the client that they have already signed the informed consent may not eﬀectively address their fears and concerns. Reassurance and support should be provided, and involving the charge nurse and healthcare team is essential to address the client's emotional well-being.

In summary, when a preoperative client confides in the practical nurse (PN) about being frightened and unsure about undergoing surgery, the priority action is to notify the charge nurse of the client's concerns. This allows for appropriate interventions, support, and coordination of care to address the client's fears, ensure their emotional well-being, and provide necessary information about the surgical procedure.

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Patient Data. Exhibits What are the signs and symptoms of DKA? Select all that apply.

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client who has been prescribed propranolol for the treatment of arrhythmias reports experiencing shortness of breath and difficulty breathing while lying down at night. Which of the following should the nurse instruct the client to do?

Correct Answer is A

Explanation

A male preoperative client who has already signed the informed consent for a surgical procedure confides in the practical nurse (PN) that he is really frightened and unsure about undergoing the surgery. Which priority action should the PN take?

Correct Answer is C

Explanation

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Patient Data.

Exhibits

What are the signs and symptoms of DKA? Select all that apply.