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 D

Explanation

Choice A reason: Respiratory alkalosis with uncompensated imbalance would show a low PaCO2, not a normal value.

Choice B reason: Respiratory acidosis with partially compensated imbalance would show a low pH and high PaCO2 with an elevated bicarbonate level.

Choice C reason: Metabolic acidosis with uncompensated imbalance would show a low pH and low bicarbonate level.

Choice D reason: Metabolic alkalosis with partially compensated imbalance is indicated by the elevated pH and bicarbonate level, while

A. Perform weekly occult blood testing with gastric analysis test. B. Discuss nutritional management with inclusion of high-protein, high-vitamin diet. C. Leave ostomy site open to air for an hour each day when changing the appliance. D. Instruct the patient and family how to give medications through their G-tube.

Correct Answer is B

Explanation

Choice A reason: Performing weekly occult blood testing with gastric analysis is not typically required for managing IBD at home. This intervention is more invasive and usually performed under specific medical instructions rather than as a routine home care intervention.

Choice B reason: Discussing nutritional management with the inclusion of a high-protein, high-vitamin diet is crucial for patients with IBD. These patients often experience malnutrition due to poor absorption and increased nutritional needs during flare-ups. A high-protein, high-vitamin diet can help promote healing, maintain muscle mass, and prevent deficiencies.

Choice C reason: Leaving the ostomy site open to air for an hour each day when changing the appliance is not recommended. Ostomy sites need to be kept clean and protected to prevent infection and skin irritation.

Choice D reason: Instructing the patient and family on how to give medications through their G-tube is not relevant if the patient has an ileostomy. The focus should be on ostomy care and management

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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?

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Correct Answer is D

Explanation

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Correct Answer is B

Explanation

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