The client is admitted to the ICU diagnoses with DKA. Which interventions should the nurse implement? (Select the 4 correct answers).(Select All that Apply.)

Push IV potassium

Administer intravenous potassium

Assess fluid volume status

Check for urinary ketones

Maintain adequate ventilation

Answer and Explanation

Correct Answer : B,C,D,E

A. Push IV potassium: Potassium should be administered slowly and with caution, as administering potassium too rapidly can cause cardiac arrhythmias. Potassium should only be given according to specific protocols and after monitoring serum potassium levels.

B. Administer intravenous potassium: In diabetic ketoacidosis (DKA), potassium levels often decrease due to insulin therapy, which shifts potassium into cells. Intravenous potassium is often required to replace lost potassium and prevent dangerous complications.

C. Assess fluid volume status: In DKA, the client experiences significant fluid loss due to polyuria (frequent urination) and dehydration. It is important to closely monitor the client’s fluid volume status and correct it with intravenous fluids, typically normal saline.

D. Check for urinary ketones: Urinary ketones are a key marker in diagnosing DKA. The nurse should monitor for the presence of ketones in the urine as it helps assess the degree of ketosis and the effectiveness of treatment.

E. Maintain adequate ventilation: In DKA, respiratory compensation (such as Kussmaul breathing) is common as the body attempts to correct acidosis. Adequate ventilation should be ensured to support the respiratory system and correct the metabolic acidosis.

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Correct Answer is D

Explanation

A. Gestational, requiring therapy for a very short time: Oral hypoglycemic agents are typically not recommended for gestational diabetes, as insulin is usually the preferred treatment for managing blood glucose levels during pregnancy.

B. Type 1, not stable with insulin administration only: Type 1 diabetes is characterized by insulin deficiency. Oral hypoglycemic agents are designed for type 2 diabetes, where the body still produces insulin but has insulin resistance.

C. Type 1 and type 2, not controlled by diet and exercise: Oral hypoglycemic agents are typically not used for type 1 diabetes. These medications are primarily for type 2 diabetes, when diet and exercise alone are insufficient to manage blood sugar.

D. Type 2, not controlled with diet and exercise: Oral hypoglycemic agents are used in the treatment of type 2 diabetes when diet and exercise alone are insufficient to manage blood glucose levels. These medications help improve insulin sensitivity, stimulate insulin production, or decrease glucose production in the liver.

A. The patient eats a high-carbohydrate snack before the exercise period. B. The patient reduces insulin use during days when exercise periods are planned. C. The patient should know blood sugar before activity. D. The patient administers insulin after exercise rather than before exercise.

Correct Answer is C

Explanation

A. The patient eats a high-carbohydrate snack before the exercise period: It is important for a patient with type 1 diabetes to ensure they have adequate glucose levels for exercise. Eating a high-carbohydrate snack before exercise is not always necessary unless blood glucose is low.

B. The patient reduces insulin use during days when exercise periods are planned: Insulin needs may be adjusted in relation to exercise, but reducing insulin across the board is not recommended without professional guidance.

C. The patient should know blood sugar before activity: It is important for patients with type 1 diabetes to check their blood sugar before exercise to ensure it is in a safe range. If the blood sugar is too low, they should consume a carbohydrate to prevent hypoglycemia.

D. The patient administers insulin after exercise rather than before exercise: Insulin should be timed appropriately to cover food intake and prevent post-meal hyperglycemia. Delaying insulin until after exercise could lead to high blood sugar levels.

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The client is admitted to the ICU diagnoses with DKA. Which interventions should the nurse implement? (Select the 4 correct answers).(Select All that Apply.)

Nursing Test Bank

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