Which condition may be observed due to incorrect fluid replacement with hypotonic fluids in patients with diabetic ketoacidosis?

Cerebral edema

Polyuria

Hypokalemia

Metabolic acidosis

Answer and Explanation

The Correct Answer is A

A. Cerebral edema is the most dangerous complication associated with the administration of hypotonic fluids in patients with diabetic ketoacidosis (DKA). This occurs because hypotonic fluids cause rapid shifts in fluid and electrolytes, which can lead to swelling of the brain, especially in children. The risk is heightened if fluids are replaced too quickly.
B. Polyuria is a common symptom of diabetic ketoacidosis due to high blood glucose levels and osmotic diuresis, but it is not caused by hypotonic fluid administration.
C. Hypokalemia is a potential risk in DKA but typically arises from the shift of potassium from the extracellular to intracellular space during treatment, especially with insulin administration, not from the use of hypotonic fluids.
D. Metabolic acidosis is a hallmark of diabetic ketoacidosis itself and is caused by the accumulation of ketones. It is not caused by hypotonic fluid replacement.

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Correct Answer is B

Explanation

A. Have the client refrain from talking for 24 hr.: This is unnecessary; the client may talk once the effects of the local anesthetic wear off, typically within an hour or two after the procedure.
B. Withhold food and liquids until the client's gag reflex returns: This is the most important action to prevent aspiration. After a bronchoscopy, the throat is anesthetized, and eating or drinking before the gag reflex returns increases the risk of aspiration.
C. Irrigate the client's throat every 4 hr.: This is not a routine post-procedure intervention and could be uncomfortable for the client.
D. Suction the client's oropharynx frequently: Suctioning should only be performed if the client has difficulty clearing secretions. There is no routine need for frequent suctioning after a bronchoscopy unless clinically indicated.

A. Maintain an IV of 0.45% sodium chloride. B. Restrict fluid intake to 1,000 mL per day. C. Provide a diet containing 2 g of sodium per day. D. Administer desmopressin acetate 0.2 mg orally.

Correct Answer is B

Explanation

A. Maintaining an IV of 0.45% sodium chloride would not be appropriate for SIADH because it is a hypotonic solution, and it could exacerbate the already low sodium levels in the patient, potentially worsening hyponatremia.
B. Fluid restriction is the primary treatment for SIADH as it helps reduce water retention, which is causing the dilution of sodium in the blood. Restricting fluid intake to 1,000 mL per day helps manage hyponatremia in these patients.
C. A diet containing 2 g of sodium per day is not typically indicated in SIADH. Restricting fluid is the main focus, and increasing sodium intake can often be counterproductive in SIADH, as the sodium imbalance is primarily due to excessive water retention.
D. Desmopressin acetate is typically used in diabetes insipidus, not SIADH. Desmopressin acts as an antidiuretic hormone (ADH) agonist, which would worsen the water retention in SIADH, not improve it.

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Which condition may be observed due to incorrect fluid replacement with hypotonic fluids in patients with diabetic ketoacidosis?

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Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who just had a flexible bronchoscopy. Which of the following nursing actions is appropriate?

Correct Answer is B

Explanation

A nurse is caring for a client who has syndrome of inappropriate antidiuretic hormone (SIADH) and a sodium level of 123 mEq/L. Which of the following prescriptions should the nurse anticipate?

Correct Answer is B

Explanation

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Which condition may be observed due to incorrect fluid replacement with hypotonic fluids in patients with diabetic ketoacidosis?

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