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Diabetic Ketoacidosis Nclex Questions

Like This Study Set?

Like This Study Set?

A client with a diagnosis of diabetic ketoacidosis (DKA) is being treated in the emergency department. Which findings would the nurse expect to note as confirming this diagnosis? Select all that apply. 1. Increase in pH 2. Comatose state 3. Deep, rapid breathing 4. Decreased urine output 5. Elevated blood glucose level 6. Low plasma bicarbonate level 3,5,6 Rationale: In DKA, the arterial pH is lower than 7.35, plasma bicarbonate is lower than 15 mEq/L, the blood glucose level is higher than 250 mg/dL, and ketones are present in the blood and urine. The client would be experiencing polyuria, and Kussmaul's respirations (deep and rapid breathing pattern) would be present. A comatose state may occur if DKA is not treated, but coma would not confirm the diagnosis. The nurse teaches a client with diabetes mellitus about differentiating between hypoglycemia and ketoacidosis. The client demonstrates an understanding of the teaching by stating that a form of glucose should be taken if which symptoms develop? Select all that apply. 1. Polyuria 2. Shakiness 3. Palpitations 4. Blurred vision 5. Lightheadedness 6. Fruity breath odor 2,3,5 A client is admitted to a hospital with a diagnosis of diabetic ketoacidosis (DKA). The initial blood glucose level was 950 mg/dL. A continuous intravenous infusion of short-acting insulin is initiated, along with intravenous rehydration with normal saline. The serum glucose level is now 240 mg/dL. The nurse would next prepare to administer which item? 1. Ampule of 50% dextrose 2. NPH insulin subcutaneously 3. Intravenous fluids containing dextrose 4. Phenytoin (Dilantin) for the prevention of seizures 3 Rationale: During management of DKA, when the blood glucose level falls to 250 to 300 mg/dL, the infusion rate is reduced and a dextrose solution Continue reading >>

Ncelx/haad/dha/moh -study Help: Diabetic Ketoacidosis And Hyperglycemic Hyperosmolar Nonketotic Syndrome

Ncelx/haad/dha/moh -study Help: Diabetic Ketoacidosis And Hyperglycemic Hyperosmolar Nonketotic Syndrome

NCELX/HAAD/DHA/MOH -STUDY HELP: Diabetic ketoacidosis and Hyperglycemic Hyperosmolar Nonketotic Syndrome Diabetic ketoacidosis and Hyperglycemic Hyperosmolar Nonketotic Syndrome Causes: no insulin present in the body or illness/infection Main problems arehyperglycemia,ketones, andacidosis(blood pH <7.35) Clinical signs/symptoms:Kussmaul breathing,fruity breath,abdominal pain Treatment is the sameas in HHNS (fluids, electrolyte replacement, and insulin) Watchpotassium levelsclosely when giving insulin and make sure the level is at least3before administrating. DKA is an acute complication of diabetes mellitus (usually type 1 diabetes) characterized by hyperglycemia, ketonuria, acidosis, and dehydration. Late Kussmauls respirations (deep respirations). Serum glucose level is usually elevated over 300 mg/dL; may be as high as 1,000 mg/dL. Serum and urine ketone bodies are present. Serum bicarbonate and pH are decreased due to metabolic acidosis, and partial pressure of carbon dioxide is decreased as a respiratory compensation mechanism. Serum sodium and potassium levels may be low, normal, or high due to fluid shifts and dehydration, despite total body depletion. BUN, creatinine, hemoglobin, and hematocrit are elevated due to dehydration. Urine glucose is present in high concentration and specific gravity is increased, reflecting osmotic diuresis and dehydration. Assess skin for dehydrationpoor turgor, flushing, or dry mucous membranes. Observe for cardiac changes reflecting dehydration, metabolic acidosis, and electrolyte imbalancehypotension; tachycardia; weak pulse; electrocardiographic changes, including elevated P wave, flattened T wave or inverted, prolonged QT interval. Assess respiratory statusKussmauls respirations, acetone breath characteristic of metabolic acido Continue reading >>

Dka (diabetic Ketoacidosis): Real Life In The Emergency Room

Dka (diabetic Ketoacidosis): Real Life In The Emergency Room

This is the first in a series from Susan Dupont RN BSN who is an Emergency Room Nurse and contributor at NRSNG.com . . . Click to View All Articles in the “Real Life in the ER Series” Every patient is a mystery that needs to be solved. Some are easy, some are complex, some aren’t solvable, but the thrill of a good challenge is what keeps me coming back for more. The emergency room is full of unsolved mystery’s. Every once in a while a mystery worth writing about comes along. Altered Mental Status? It was like any normal shift. I had just discharged a patient and walked them out of the ER to turn around and see an EMS stretcher waiting to enter my room. I hadn’t even cleaned the room yet. I grabbed a piece of paper and pen and walked into my favorite type of patient, Altered Mental Status. This patient, a 20-year-old female, had been found wandering around the streets and stumbling around. She didn’t know her name and when she attempted to talk, random words were coming out of her mouth. She would only respond to a sternal rub and her breath was fruity. Vital signs: BP 80/48 mmHg Respirations of 32 Heart rate 125 bpm (sinus tachycardia on her EKG). After getting a reading of >500 blood glucose on the glucometer, we started the search for an IV. This was the challenge of the night. This little girl had absolutely tiny veins that were hidden. Her first IV gave us blood but after starting a bolus of normal saline the line infiltrated, causing a grape sized lump on her forearm. The next IV was in her hand and it worked but was only a 22 gauge. We needed better IV access. After using the infrared goggles and ultrasound we got 2 IV’s, one in each antecubital. Suspicious of Diabetic Ketoacidosis, her lab work confirmed the diagnosis. Her blood work showed: Glucose Continue reading >>

Diabetes Mellitus Complications (hhns And Dka) Nclex

Diabetes Mellitus Complications (hhns And Dka) Nclex

HHS is typically seen in patients with type 2 diabetes and infection, such as pneumonia. The main presenting sign is a glucose level above 600 mg/dL. Enough evidence of dehydration already exists that orthostatic vital sign assessments are not a priority, and they are often inaccurate in the elderly due to poor vascular tone. Patients with HHS do not have elevated ketone levels, which is a key distinction between HHS and DKA. Temperature will eventually be taken but is often blunted in the elderly and diabetics. An infectious diagnosis has already been made. The glucose level for appropriate fluid and insulin treatment is the priority. The patient with HHS presented with a glucose level of 800 mg/dL and is started on IV fluids and insulin. What action do you anticipate when the patient's glucose reaches 250 mg/dL? A. Administer an intravenous (IV) solution with 5% dextrose. B. Administer sodium polystyrene sulfate (Kayexalate). C. Slow the IV infusion rate to 40 mL/hour. D. Assess cardiac monitoring for peaked T waves. A. Administer an intravenous (IV) solution with 5% dextrose. When blood glucose levels fall to approximately 250 mg/dL, IV fluids containing glucose are administered to prevent hypoglycemia. Kayexalate (for cation exchange) is used in the treatment of hyperkalemia, which causes peaked T waves on cardiac monitoring. In HHS hypokalemia may result from insulin moving the potassium intracellularly. Fluid replacement remains a priority, but it is given with dextrose. The infusion rate of 40 mL/hour keeps the vein open, but it is not the appropriate replacement rate. What is a typical finding of hyperosmolar hyperglycemic syndrome (HHS)? A. Occurs in type 1 diabetes as the presenting symptom B. Slow onset resulting in a blood glucose level greater than 600 mg/ Continue reading >>

Heard About The New Nclex?

Heard About The New Nclex?

Here's what the buzz is about on alternative-item questions. See what the buzz is about on the new alternative-item questions now in NCLEX. RECENTLY, THE NATIONAL COUNCIL of State Boards of Nursing (NCSBN) added three types of alternative-item questions to the licensing exam it administers. Here are some examples of the new types of questions in the National Council Licensure Examination for Registered Nurses (NCLEX-RN) and the National Council Licensure Examination for Practical/Vocational Nurses (NCLEX-PN). 1. Multiple-response multiple-choice questions These questions may have more than one correct answer and may contain more than four possible answer options. You'll be asked to select all the answers that apply, not just the best answer. Sample question (and answer with rationale) While preparing a client for an upper GI endoscopy (esophagogastroduodenoscopy), the nurse should implement which of the following interventions? Select all that apply: A. Administer a preparation to clean the GI tract, such as Golytely or Fleet Phospho-Soda. B. Tell the client he shouldn't eat or drink for 6 to 12 hours before the procedure. C. Tell the client he must be on a clear liquid diet for 24 hours before the procedure. D. Inform the client that he'll receive a sedative before the procedure. E. Tell the client that he may eat and drink immediately after the procedure. The client shouldn't eat or drink for 6 to 12 hours before the procedure to ensure that his upper GI tract is clear for viewing. The client will receive a sedative before the endoscope is inserted that will help him relax, but allow him to remain conscious. A GI tract cleansing and a clear liquid diet are interventions for a client having a lower GI tract procedure, such as a colonoscopy. Food and fluids must be wit Continue reading >>

Diabetes Nclex Questions

Diabetes Nclex Questions

1. A patient with newly diagnosed type 2 diabetes mellitus asks the nurse what type 2 means in relation to diabetes. The nurse explains to the patient that type 2 diabetes differs from type 1 diabetes primarily in that with type 2 diabetes a. the pt is totally dependent on an outside source of insulin b. there is a decreased insulin secretion and cellular resistance to insulin that is produced c. the immune system destroys the pancreatic insulin-producing cells d. the insulin precurosr that is secreted by the pancreas is not activated by the liver Answer B Rationale: In type 2 diabetes, the pancreas produces insulin, but the insulin is insufficient for the bodys needs or the cells do not respond to the insulin appropriately. The other information describes the physiology of type 1 diabetes 18. The benefits of using an insulin pump include all of the following except: a. By continuously providing insulin they eliminate the need for injections of insulin b. They simplify management of blood sugar and often improve A1C c. They enable exercise without compensatory carbohydrate consumption D: Using an insulin pump has many advantages, including fewer dramatic swings in blood glucose levels, increased flexibility about diet, and improved accuracy of insulin doses and delivery; however, the use of an insulin pump has been associated with weight gain. A 54-year-old patient admitted with type 2 diabetes, asks the nurse what type 2 means. Which of the following is the most appropriate response by the nurse? 1. With type 2 diabetes, the body of the pancreas becomes inflamed. 2. With type 2 diabetes, insulin secretion is decreased and insulin resistance is increased. 3. With type 2 diabetes, the patient is totally dependent on an outside source of insulin. 4. With type 2 diabetes, Continue reading >>

Management Of Diabetic Ketoacidosis In Adults

Management Of Diabetic Ketoacidosis In Adults

Diabetic ketoacidosis is a potentially life-threatening complication of diabetes, making it a medical emergency. Nurses need to know how to identify and manage it and how to maintain electrolyte balance Continue reading >>

Nclex Review

Nclex Review

A nurse is providing education to a group of young adults regarding development of type 2 diabetes. Which information should be included? Select all that apply. While hospitalized for a myocardial infarction, the patient is diagnosed with type 2 diabetes and is started on an oral antidiabetic medication. Which patient statement should the nurse correct? An insulin-dependent type 1 diabetic patient is admitted in a diabetic coma with a blood glucose of 65 mg/dL. The client's spouse says, "I don't see how this can have happened. We were working in the yard together and she seemed just fine until she collapsed." What explanation would the nurse offer? A patient is brought to the Emergency Department with suspected diabetic ketoacidosis. Which clinical manifestations would support this diagnosis? Select all that apply. It is suspected that a patient has diabetic ketoacidosis. Which anion gap measurement would support that supposition? Which patient history would the nurse evaluate as increasing risk for development of hyperglycemic hyperosmolar state (HHS)? Select all that apply. A patient is being treated for diabetic ketoacidosis (DKA). Acidosis is being corrected and the client's urine output is approaching normal. Which lab value is most important for the nurse to monitor? A patient is being treated for diabetic ketoacidosis (DKA). Which cardiac monitor changes would the nurse evaluate as most significant? Select all that apply. Continue reading >>

Type 1 Diabetes | Remar Review For Nclex

Type 1 Diabetes | Remar Review For Nclex

The primary treatment for type 1 diabetes will be insulin injection. The insulin injections could range from 1-7 times a day with a combination of short and long acting insulin . This is important because if insulin is not available for energy consumption the body will burn fats. When fat breakdown occurs, the result is ketone production. If ketones are present in the body; clients are at risk for diabetic ketoacidosis. Diabetic Ketoacidosis (DKA) is a life threatening condition that occurs when not enough insulin is present. The three main symptoms are: The ketone production will create an acidotic state in the body. Dehydration will be caused by excessive urination, clients may lose up to 6 liters a day. Hyperglycemia is caused due to a lack of insulin. Other signs of DKA: fruity breath, abdominal pain, nausea, vomiting, hyperventilation Treatment for DKA will be IV fluid + electrolytes and Regular Insulin IV. The Insulin will reverse both the acidosis and hyperglycemia. What is the primary way type 1 diabetes is controlled? What is the life threatening condition that can occur if type 1 diabetes is uncontrolled? If ketones are present in the body should the client exercise? What is the treatment for diabetic ketoacidosis? **Remember if insulin injection is the primary mode of treatment for type 1 diabetes education will be the key. Continue reading >>

Diabetic Ketoacidosis Nclex Questions

Diabetic Ketoacidosis Nclex Questions

This quiz on DKA (Diabetic Ketoacidosis NCLEX Questions) will test you on how to care for the diabetic patient who is experiencing this condition. As the nurse, you must know typical signs and symptoms of DKA, patient teaching, and expected medical treatments. 1 Relapsed Multiple Myeloma - Get The Facts Learn More About Relapsed Multiple Myeloma at the Official Physician Site. Prescription treatment website 2 Login to Your Account Sign In To Your Email! emailloginnow.com Diabetic Ketoacidosis and Hyperglycemic Hyperosmolar Nonketotic Syndrome (HHNS) are both complication of diabetes mellitus, but there are differences between the two complications that you must know as a nurse. This endocrine teaching series will test your knowledge on how to differentiate between the two conditions, along with a video lecture. This DKA quiz will test you on the following for the NCLEX exam: Signs and Symptoms of Diabetic Ketoacidosis Causes of Diabetic Ketoacidosis Patient education for DKA Treatments of Diabetic Ketoacidosis NCLEX Review Nursing Lecture on DKA (NOTE: When you hit submit, it will refresh this same page. Scroll down to see your results.) 1. Which of the following is not a sign or symptom of Diabetic Ketoacidosis? A. Positive Ketones in the urine B. Oliguria C. Polydipsia D. Abdominal Pain 2. A patient is admitted with Diabetic Ketoacidosis. The physician orders intravenous fluids of 0.9% Normal Saline and 10 units of intravenous regular insulin IV bolus and then to start an insulin drip per protocol. The patient’s labs are the following: pH 7.25, Glucose 455, potassium 2.5. Which of the following is the most appropriate nursing intervention to perform next? A. Start the IV fluids and administer the insulin bolus and drip as ordered B. Hold the insulin and notify the d Continue reading >>

Diabetic Ketoacidosis

Diabetic Ketoacidosis

INTRODUCTION Diabetic ketoacidosis (DKA) is a very serious complication of diabetes mellitus, a metabolic disorder that is characterized by hyperglycemia, metabolic acidosis, and increased body ketone concentrations. The most common causes of DKA are infection and poor compliance with medication regimens. Other causes include undiagnosed diabetes, alcohol abuse, and a multitude of medical conditions such as cerebrovascular accident (CVA), complicated pregnancy, myocardial infarction, pancreatitis, and stress. Diabetic ketoacidosis is a complicated pathology. Early recognition of DKA, a good understanding of the pathological processes of DKA, and aggressive treatment are the keys to successful treatment. With good care, DKA can be managed and the patient will survive. OBJECTIVES When the student has finished studying this module, he/she will be able to: 1. Identify the correct definition of DKA. 2. Identify a basic function of insulin. 3. Identify the insulin derangements of types I and II diabetes. 4. Identify the basic cause of DKA. 5. Identify two specific causes of DKA. 6. Identify the two pathogenic mechanisms that produce the signs/symptoms of DKA. 7. Identify metabolic consequences of increased hormone concentrations in DKA. 8. Identify the criteria used to diagnose DKA. 9. Identify common signs and symptoms of DKA. 10. Identify laboratory abnormalities seen in DKA. 11. Identify complications of DKA. 12. Identify the three most important therapies for treating DKA. 13. Identify the correct roles of sodium bicarbonate and phosphate in treating DKA. 14. Identify an important rule for using potassium replacement in DKA. 15. Identify an important rule for switching from IV to subcutaneous insulin. EPIDEMIOLOGY Most cases of DKA are seen in patients with type I diabete Continue reading >>

Dka Questions - 1 Which Of The Following Is Not A Sign Or...

Dka Questions - 1 Which Of The Following Is Not A Sign Or...

dka questions - 1 Which of the following is not a sign or... 1. Which of the following is not a sign or symptom of Diabetic Ketoacidosis?A. Positive Ketones in the urineB. OliguriaC. PolydipsiaD. Abdominal Pain2. A patient is admitted with Diabetic Ketoacidosis. The physician orders intravenous fluids of 0.9% Normal Saline and 10 units of intravenous regular insulin IV bolus and then to start an insulin drip per protocol. The patients labs are the following: pH 7.25, Glucose 455, potassium 2.5. Which of the following is the most appropriate nursing intervention to perform next?3. Which patient is MOST likely to develop Diabetic Ketoacidosis?4. Which of the following statements are INCORRECT about Diabetic Ketoacidoisis? This preview has intentionally blurred sections. Sign up to view the full version. 5. True or False: When priming the tubing for an Insulin infusion it is best practice to waste 50cc to 100cc of insulin prior to starting the infusion because insulin absorbs into the plastic lining of the tubing.6. You are providing care to a patient experiencing diabetic ketoacidosis. The patient is on an insulin drip and their current glucose level is 300. In addition to this, the patient also has 5% Dextroxe 0.45% NS infusing in the right antecubital vein. Which of the following patient signs/symptoms causes concern?A. Patient has a potassium level of 2.3B. Patient complains of thirst.c. Patient is nauseous.D. Patients skin and mucous membranes are dry.7. What type of insulin do you expect the doctor to order for treatment of DKA?8. A patient diagnosed with diabetes mellitus is being discharged home and you are teaching them about preventing DKA. What statement by the patient demonstrates they understood your teaching about this condition?Answer Key: This is the end o Continue reading >>

Its Back! The Nclex Question Of The Week Ati Nursing Blog

Its Back! The Nclex Question Of The Week Ati Nursing Blog

ITS BACK! THE NCLEX QUESTION OF THE WEEK When it comes to the NCLEX Exam, its best to be as prepared as possible. Each week, the ATI Nursing Education Facebook page will be sharing the NCLEX Question of the Week to help you prep. Each NCLEX-style question is reflective of a question that you could receive on the test, plus its paired with helpful rationales to help explain the answer. Follow along! Follow ATI Nursing on Facebook, here. Question: A client who is diagnosed with diabetic ketoacidosis has a serum glucose level of 580 mg/dL and a potassium level of 5.7 mEq/L. Vital signs include: Blood pressure 88/54 mm Hg; Heart rate 136/min; Respiratory rate 40/min. Which action should the nurse implement first? C. Administer 6 units regular insulin subcutaneously. D. Infuse 1 liter of 0.9% sodium chloride over an hour. A. The nurse should reassess blood glucose every hour to evaluate the effectiveness of therapy. When the blood glucose level reaches 300 mg/dL, IV solutions containing dextrose should be initiated to prevent hypoglycemia and cerebral edema. B. Serum potassium levels drop once therapy is initiated. Potassium replacement is started after serum potassium levels fall below 5.0 mEq/L. The maximum infusion rate for adults should not exceed 10 mEq of potassium per hour. C. Subcutaneous insulin has a delayed onset of action and should be administered once the client can take oral fluids and ketosis has stopped. Therefore, unless DKA is mild, a continuous IV infusion of regular insulin should be started. An initial IV bolus of regular insulin may be given at the beginning of the infusion. D. CORRECT: The priority action is to restore volume and maintain perfusion to the brain, heart and kidneys. Hyperglycemia leads to osmotic diuresis and dehydration resulting in t Continue reading >>

Dka Vs Hhns Nclex Questions

Dka Vs Hhns Nclex Questions

This quiz on DKA vs HHNS (Diabetic Ketoacidosis vs Hyperglycemic Hyperosmolar Nonketotic Syndrome) will test you on how to care for the diabetic patient who is experiencing these conditions. As the nurse, you must know typical signs and symptoms of DKA and HHNS, patient teaching, and expected medical treatments. Diabetic Ketoacidosis and Hyperglycemic Hyperosmolar Nonketotic Syndrome (HHNS) are both complication of diabetes mellitus, but there are differences between the two complications that you must know as a nurse. This endocrine teaching series will test your knowledge on how to differentiate between the two conditions, along with a video lecture. This quiz will test you on the following for the NCLEX exam: Signs and Symptoms of Diabetic Ketoacidosis vs Hyperglycemic Hyperosmolar Nonketotic Syndrome Causes of Diabetic Ketoacidosis vs Hyperglycemic Hyperosmolar Nonketotic Syndrome Patient education for DKA vs HHNS Treatments of Diabetic Ketoacidosis vs Hyperglycemic Hyperosmolar Nonketotic Syndrome Lecture on DKA vs HHS (NOTE: When you hit submit, it will refresh this same page. Scroll down to see your results.) DKA vs HHS Quiz 1. This complication is found mainly in Type 2 diabetics? 2. A patient is found to have a blood glucose of 375 mg/dL, positive ketones in the urine, and blood pH of 7.25. Which condition is this? 3. Hyperglycemic Hyperosmolar Nonketotic Syndrome would have all of the following signs and symptoms EXPECT? A. Dry mucous membranes B. Polyuria C. Blood glucose >600 mg/dL D. Kussmaul breathing 4. This condition happens gradually and is more likely to affect older adults? 5. A patient has an infection and reports not checking their blood glucose or regularly taking Metformin. What condition is this patient MOST at risk for? A. DKA B. HHNS C. Metabol Continue reading >>

Diabetes Mellitus Nclex Practice Quiz #1 (40 Questions)

Diabetes Mellitus Nclex Practice Quiz #1 (40 Questions)

This exam is all about Diabetes Mellitus! The purpose of this exam is to provide nurses and future nurses an overview of the disease, including its management, impact, and complications. Accomplish this 40-item NCLEX style examination and guarantee a good performance on your NCLEX. Though no one can go back and make a brand new start, anyone can start from now and make a brand new ending. ~ Carl Bard Topics Included topics in this practice quiz are: Guidelines Follow the guidelines below to make the most out of this exam: Read each question carefully and choose the best answer. You are given one minute per question. Spend your time wisely! Answers and rationales are given below. Be sure to read them. If you need more clarifications, please direct them to the comments section. Questions See Also You may also like these quizzes: 3,500+ NCLEX-RN Practice Questions for Free – Tons of practice questions for various topics in the NCLEX-RN! Study Guides Cardiovascular System Respiratory System Nervous System Digestive and Gastrointestinal System Endocrine System Urinary System Homeostasis: Fluids and Electrolytes Cancer and Oncology Nursing Burns and Burn Injury Management Emergency Nursing Miscellaneous Recommended Books and Resources Selected NCLEX-RN review books: MUST HAVE: Saunders Comprehensive Review for the NCLEX-RN® Examination, 7th Edition – A must have book if you're taking the NCLEX-RN. You need to have this. Saunders Strategies for Success for the NCLEX – An invaluable guide that will help you master what matters most in passing nursing school and the NCLEX. Mosby's Comprehensive Review of Nursing for NCLEX-RN – This book has helped nurses pass the NCLEX exam for over 60 years. Practice with over 600 alternative item question formats. Prioritization, Dele Continue reading >>

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