The nurse is teaching an adult client with Type 1 diabetes that causes for the development of diabetic ketoacidosis (DKA) are (SELECT ALL THAT APPLY)

an upper urinary tract infection

decreased caloric intake

aerobic exercise

clogged tubing of a subcutaneous insulin pump

not taking sufficient insulin

Answer and Explanation

Correct Answer : A,B,D,E

A.   Infections, including urinary tract infections, can increase insulin resistance and elevate blood glucose levels, potentially leading to DKA. The stress response from infection can also increase cortisol levels, further contributing to hyperglycemia.
B.   Decreased caloric intake can lead to inadequate insulin levels relative to the body’s needs. In Type 1 diabetes, if insulin is not sufficient to metabolize glucose (due to low intake or other reasons), the body may resort to fat metabolism, leading to the production of ketones and the development of DKA.
C.   While exercise can affect blood glucose levels, it typically lowers them and is not a direct cause of DKA. In fact, moderate aerobic exercise is usually encouraged for managing diabetes. However, if blood glucose levels are already high before exercise, it may exacerbate the situation, but aerobic exercise itself is not a cause of DKA.
D.   Clogged tubing can prevent insulin delivery, leading to insufficient insulin levels. This lack of insulin can result in elevated blood glucose levels and, ultimately, the risk of DKA if not addressed.
E.   Not taking enough insulin is a primary cause of DKA in Type 1 diabetes. Without adequate insulin, the body cannot utilize glucose properly, leading to increased fat metabolism and the production of ketones, which can cause DKA.

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Correct Answer is B

Explanation

This is the correct time to draw the peak level. The peak level is the highest concentration of the drug in the blood, which typically occurs about 30 minutes to an hour after the end of the infusion.

A. Notify the physician since this is a sign of deterioration. B. Offer the client back massage to reduce the pain. C. Place the client in prone position to limit vesicoureteral reflux. D. Offer the client an analgesic if prescribed.

Correct Answer is D

Explanation

A. While costovertebral tenderness is significant and indicates kidney involvement, it is a common symptom of acute pyelonephritis and not necessarily a sign of deterioration. Immediate notification may not be warranted unless other concerning symptoms are present.
B. Although back massage may seem comforting, it is not indicated in this scenario. The kidneys are inflamed, and massage could exacerbate pain or discomfort. It does not address the underlying condition or the pain effectively.
C. The prone position is not typically recommended for clients with pyelonephritis. Instead, the client may be more comfortable in a position that does not put pressure on the kidneys, such as sitting up or lying on their back or side. This intervention does not directly address the pain or comfort of the client.
D. Offering an analgesic is the most appropriate action. Pain management is crucial for the comfort of the client, and an analgesic can help alleviate the discomfort associated with costovertebral tenderness. If the physician has prescribed an analgesic, administering it would be in line with promoting comfort and addressing the client’s needs.

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The nurse is teaching an adult client with Type 1 diabetes that causes for the development of diabetic ketoacidosis (DKA) are (SELECT ALL THAT APPLY)

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Naxlex Comprehensive Predictor Exams

A client is receiving gentamicin every 12 hours IVPB for an infection. The nurse has administered the 0800 dose, which is prescribed to run over 1 hour. The physician prescribed peak and trough levels to be drawn. The nurse recognizes that the peak level will be drawn at

Correct Answer is B

Explanation

A 72-year-old client is admitted to the medical-surgical unit with a diagnosis of acute pyelonephritis. The client complains of costovertebral tenderness. What it the most appropriate nursing intervention?

Correct Answer is D

Explanation

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