The nurse is caring for a patient with hyperosmolar hyperglycemic syndrome. The patient is receiving intravenous fluids of normal saline with 20 mEq of potassium chloride and a continuous insulin infusion. Which finding will indicate to the nurse that the treatment is effective?

Normal blood pressure, deep respirations

Increased alertness, normal heart rhythm

High urine specific gravity, normal temperature

Blood glucose of 250 mg/dL, disorientation

Answer and Explanation

The Correct Answer is B

Choice A reason: Normal blood pressure and deep respirations do not necessarily indicate that hyperosmolar hyperglycemic syndrome is resolving. Deep respirations, also known as Kussmaul respirations, can occur in response to severe hyperglycemia.

Choice B reason: Increased alertness and a normal heart rhythm suggest that the patient's neurological status and cardiovascular system are stabilizing, which are positive indicators that the treatment is effective in managing hyperosmolar hyperglycemic syndrome.

Choice C reason: High urine specific gravity and normal temperature do not directly indicate the effectiveness of treatment for hyperosmolar hyperglycemic syndrome. High urine specific gravity can result from dehydration.

Choice D reason: A blood glucose level of 250 mg/dL with disorientation still indicates poorly controlled hyperglycemia and ongoing metabolic disturbance, which means the treatment is not yet effective.

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Correct Answer is C

Explanation

Choice A reason: Foot ulcers and delayed wound healing are related to diabetes but are considered macrovascular complications. Microvascular complications specifically refer to damage to small blood vessels.

Choice B reason: Stroke prevention and cardiac health are important but are related to macrovascular complications of diabetes. The focus here is on microvascular complications.

Choice C reason: Retinopathy and nephropathy are microvascular complications of diabetes. These conditions result from damage to small blood vessels in the eyes and kidneys, respectively. Diabetic retinopathy can lead to vision loss, while diabetic nephropathy can lead to kidney failure. It is important to monitor for these complications and manage blood glucose levels to prevent or slow their progression.

Choice D reason: Hypertension management and cholesterol control are important for overall cardiovascular health but are related to macrovascular complications. The discussion should focus on microvascular complications specific to diabetes.

A. Administer a rapid infusion of fluids. B. Increase the dialysis flow rate. C. Decrease the rate of dialysis. D. Apply ice packs to the patient's head. E. Monitor neurological status closely.

Correct Answer is ["C"]

Explanation

Choice A reason: Administering a rapid infusion of fluids is not appropriate for disequilibrium syndrome. This syndrome results from rapid changes in fluid and electrolyte balance during dialysis, and rapid fluid infusion could worsen the condition.

Choice B reason: Increasing the dialysis flow rate is not appropriate. Decreasing the rate of dialysis can help reduce the symptoms of disequilibrium syndrome by allowing the body to adjust more gradually.

Choice C reason: Decreasing the rate of dialysis helps to minimize the rapid shifts in fluid and electrolytes, which can exacerbate disequilibrium syndrome.

Choice D reason: Applying ice packs to the patient's head is not a standard intervention for disequilibrium syndrome. The focus should be on managing the rate of dialysis and monitoring the patient's neurological status.

Choice E reason: Monitoring neurological status closely is important because disequilibrium syndrome can cause symptoms such as headache, nausea, confusion, and seizures. Close monitoring allows for prompt intervention if symptoms worsen.

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The nurse is caring for a patient with hyperosmolar hyperglycemic syndrome. The patient is receiving intravenous fluids of normal saline with 20 mEq of potassium chloride and a continuous insulin infusion. Which finding will indicate to the nurse that the treatment is effective?

Nursing Test Bank

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Correct Answer is C

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