The nurse is caring for a patient with diabetic ketoacidosis. Which assessment finding indicates to the nurse that the patient is experiencing fluid volume deficit?

Hypotension

Bradycardia

Polyphagia

Rapid, deep respiration

Answer and Explanation

The Correct Answer is A

Choice A reason: Hypotension, or low blood pressure, is a common indicator of fluid volume deficit. When a patient is dehydrated or has a significant loss of fluids, their blood volume decreases, leading to lower blood pressure. This condition requires immediate attention and management to prevent complications such as shock or organ failure. Monitoring and correcting fluid balance is crucial in managing patients with diabetic ketoacidosis, making hypotension a significant assessment finding.

Choice B reason: Bradycardia, or slow heart rate, is not typically associated with fluid volume deficit. It is more often related to other conditions such as heart block, hypothyroidism, or use of certain medications. In the context of diabetic ketoacidosis, fluid volume deficit would not manifest primarily as bradycardia.

Choice C reason: Polyphagia, or excessive hunger, is a symptom commonly associated with diabetes mellitus but does not indicate fluid volume deficit. Polyphagia results from the body's inability to use glucose properly, leading to increased hunger. It is not directly related to the patient's hydration status or fluid volume.

Choice D reason: Rapid, deep respiration, also known as Kussmaul breathing, is a compensatory mechanism in response to metabolic acidosis, a hallmark of diabetic ketoacidosis. While it is an important clinical sign, it does not specifically indicate fluid volume deficit. Kussmaul respiration occurs due to the body's attempt to expel excess carbon dioxide and correct the acid-base imbalance.

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Correct Answer is K

Explanation

Choice A reason: Atenolol 25 mg oral tablet with breakfast is a common beta-blocker used to manage heart conditions, but it does not indicate an immediate priority.

Choice B reason: Captopril 25 mg three times a day is an ACE inhibitor used to manage blood pressure and heart failure but is not an immediate priority unless there are contraindications.

Choice C reason: Hydrochlorothiazide 25 mg twice a day is a diuretic used to manage fluid retention and blood pressure. While important, it is not the immediate priority unless there are contraindications.

Choice D reason: Aspirin 81 mg tablet every day is a common medication for preventing blood clots but is not an immediate priority unless there are contraindications or interactions.

Choice E reason: Digoxin 0.125 mg every other day is used to manage heart conditions but is not the immediate priority unless there are contraindications or interactions.

Choice F reason: Furosemide 20 mg at bedtime is a diuretic used to manage fluid retention and blood pressure. While important, it is not the immediate priority unless there are contraindications.

Choice G reason: Multivitamin one tablet daily is a common supplement and is not the immediate priority.

Choice H reason: Some doses of medication are missing, which needs to be addressed, but it is not the immediate priority.

Choice I reason: Some routes of medications are missing, which needs to be addressed, but it is not the immediate priority.

Choice J reason: Some medications are duplicated, which is important but not the immediate priority unless it poses a risk to the patient.

Choice K reason: The medications have drug-drug interactions is the priority for the nurse to address. Drug-drug interactions can lead to adverse effects and complications, especially in a patient with multiple conditions such as heart failure, asthma, and kidney disease. Ensuring that medications are safe and do not interact negatively is crucial for patient safety.

A. pH 7.48, PaCO2 30, HCO3 24 B. pH 7.41, PaCO2 45, HCO3 29 C. pH 7.31, PaCO2 34, HCO3 18 D. pH 7.25, PaCO2 59, HCO3 30

Correct Answer is A

Explanation

Choice A reason: The lab results pH 7.48, PaCO2 30, HCO3 24 indicate respiratory alkalosis. Hyperventilation leads to excessive loss of carbon dioxide (PaCO2), resulting in an increase in pH (alkaline). This is consistent with pulmonary edema and hyperventilation due to heart failure.

Choice B reason: The lab results pH 7.41, PaCO2 45, HCO3 29 indicate a normal pH with compensated metabolic alkalosis. This is not consistent with hyperventilation in pulmonary edema.

Choice C reason: The lab results pH 7.31, PaCO2 34, HCO3 18 indicate metabolic acidosis with partial compensation. This is not typical for a patient with hyperventilation and pulmonary edema.

Choice D reason: The lab results pH 7.25, PaCO2 59, HCO3 30 indicate respiratory acidosis with partial compensation. This would be consistent with hypoventilation rather than hyperventilation.

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The nurse is caring for a patient with diabetic ketoacidosis. Which assessment finding indicates to the nurse that the patient is experiencing fluid volume deficit?

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Correct Answer is K

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Correct Answer is A

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