The nurse is caring for a patient with multiple sclerosis (MS) who is experiencing changes to their bowel function. What intervention will the nurse implement for this patient?

Implement a fluid restriction of 1500 mL in 24 hours

Provide a bland, low-residue diet

Establish a bowel routine with daily stool softeners

Consult surgeon to discuss colostomy creation

Answer and Explanation

The Correct Answer is C

Choice A reason: Implementing a fluid restriction could worsen constipation and bowel function in patients with multiple sclerosis.

Choice B reason: Providing a bland, low-residue diet is less effective in managing bowel function compared to establishing a regular bowel routine.

Choice C reason: Establishing a bowel routine with daily stool softeners helps maintain regular bowel movements and prevents constipation, which is important for patients with multiple sclerosis.

Choice D reason: Consulting a surgeon for colostomy creation is a more invasive intervention that is not the first line of treatment for changes in bowel function in multiple sclerosis patients.

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Correct Answer is A

Explanation

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.

A. Kussmaul breathing B. Abdominal pain C. Positive Trousseau sign D. Decreased heart rate E. Confusion

Correct Answer is ["A","B","E"]

Explanation

Choice A reason: Kussmaul breathing is a deep, labored breathing pattern that is a compensatory mechanism for metabolic acidosis, commonly seen in diabetic ketoacidosis.

Choice B reason: Abdominal pain is a common symptom in diabetic ketoacidosis due to the metabolic disturbances and dehydration.

Choice C reason: A positive Trousseau sign is associated with hypocalcemia and is not a common manifestation of diabetic ketoacidosis.

Choice D reason: Decreased heart rate is not typical in diabetic ketoacidosis. In fact, patients might present with an increased heart rate due to dehydration and acidosis.

Choice E reason: Confusion is a symptom of diabetic ketoacidosis due to the effects of severe hyperglycemia and metabolic acidosis on the brain.

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The nurse is caring for a patient with multiple sclerosis (MS) who is experiencing changes to their bowel function. What intervention will the nurse implement for this patient?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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?

Correct Answer is A

Explanation

The nurse is caring for a patient with diabetic ketoacidosis (DKA). What clinical manifestations will the nurse anticipate the patient to present? (Select All That Apply)

Correct Answer is ["A","B","E"]

Explanation

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