The nurse is caring for a patient admitted with hyperglycemic hyperosmolar syndrome who is receiving fluid replacement therapy with normal saline at 250 mL per hour along with a continuous insulin infusion. What potential complications of this treatment will the nurse monitor the patient for? (Select All That Apply)

Ketoacidosis

Pulmonary edema

Atelectasis

Hypoglycemia

Hypokalemia

Answer and Explanation

Correct Answer : B,D,E

Choice A reason: Ketoacidosis is not a typical complication of hyperglycemic hyperosmolar syndrome (HHS) treatment. HHS usually occurs without significant ketoacidosis, and the focus is on managing hyperglycemia and dehydration.

Choice B reason: Pulmonary edema is a potential complication of rapid fluid replacement therapy. The increased fluid volume can overwhelm the heart's ability to pump effectively, leading to fluid accumulation in the lungs.

Choice C reason: Atelectasis is not a common complication of HHS treatment. It is more related to lung collapse or infection rather than fluid or insulin therapy.

Choice D reason: Hypoglycemia is a potential complication of continuous insulin infusion. Close monitoring of blood glucose levels is necessary to prevent blood sugar from dropping too low during treatment.

Choice E reason: Hypokalemia is a potential complication of insulin therapy. Insulin promotes the uptake of potassium into cells, which can reduce serum potassium levels. Monitoring and managing potassium levels is important during HHS treatment.

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Correct Answer is A

Explanation

Choice A reason: The order to administer Hydrochlorothiazide should be clarified because thiazide diuretics can increase calcium levels, which could worsen hypercalcemia in a patient with a history of hyperparathyroidism.

Choice B reason: Monitoring intake and output and daily weights are essential for managing fluid balance in heart failure patients and do not need clarification.

Choice C reason: Administering Calcitonin helps lower calcium levels, which is appropriate for treating hypercalcemia in a patient with hyperparathyroidism.

Choice D reason: Preparing the patient for possible hemodialysis may be necessary if the patient's kidney function deteriorates, especially with elevated BUN and creatinine levels.

A. Acute hemolytic B. Allergic C. Anaphylactic D. Circulatory overload

Correct Answer is B

Explanation

Choice A reason: Acute hemolytic reactions are severe and typically present with symptoms such as fever, chills, flank pain, hemoglobinuria, and shock. The patient's mild symptoms of itching and a localized rash do not match the severe presentation of an acute hemolytic reaction.

Choice B reason: Allergic reactions to blood transfusions are common and usually present with symptoms such as itching, hives, and localized rash. The patient's vital signs and physical assessment showing mild itching and a rash on the arms are consistent with an allergic reaction.

Choice C reason: Anaphylactic reactions are severe allergic reactions that involve respiratory distress, hypotension, and shock. The patient's mild symptoms do not indicate an anaphylactic reaction.

Choice D reason: Circulatory overload presents with symptoms such as dyspnea, orthopnea, hypertension, and pulmonary edema. The patient's symptoms of itching and a rash do not align with circulatory overload.

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Naxlex Comprehensive Predictor Exams

Correct Answer is A

Explanation

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Correct Answer is B

Explanation

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