The nurse is preparing to administer sodium polystyrene sulfonate (Kayexalate) rectally to a patient with an irregular pulse and weakness of the lower extremities.
What laboratory finding does the nurse determine is the reason for this treatment?

Choice A rationale

Measuring blood pressure manually is important in assessing the patient's hemodynamic status, but it is not the priority intervention in diabetic ketoacidosis (DKA). The priority is to address dehydration and electrolyte imbalances.

Choice B rationale

Administering intravenous fluids is the priority intervention for a client with DKA. Rapid, deep respirations (Kussmaul breathing) indicate severe metabolic acidosis and dehydration. IV fluids help to correct fluid deficit, improve perfusion, and decrease blood glucose levels.

Choice C rationale

Oxygen therapy may be beneficial if the client is hypoxic, but it is not the priority intervention for DKA. The primary issue is fluid deficit and metabolic acidosis.

Choice D rationale

Administering subcutaneous insulin is essential for managing hyperglycemia in DKA, but it should be done after initiating IV fluids to avoid rapid shifts in electrolyte balance.

Choice A rationale

Continuing to monitor the client's respiratory status is the appropriate action if fluctuation is observed in the suction control chamber. Fluctuations are expected and indicate that the system is functioning correctly.

Choice B rationale

Checking the suction control outlet on the wall is necessary if there are signs that the system is not functioning correctly, but fluctuation itself is not an indication of malfunction.

Choice C rationale

Checking the tubing connections for leaks is important if there is an air leak suspected. However, normal fluctuation does not suggest a leak.

Choice D rationale

Clamping the chest tube is generally avoided unless absolutely necessary as it can lead to the accumulation of air and tension pneumothorax.