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Dka Quizlet Questions

Endocrine Practice Questions (n2 Exam 2)

Endocrine Practice Questions (n2 Exam 2)

SIADH results in water retention, causing a low serum sodium level. SIADH results in water retention, causing a high urine sodium level. SIADH results in water retention, causing an increase in urine specific gravity. A nurse is caring for a client who has primary diabetes insipidus (DI). Which of the following manifestations should the nurse expect to find? Select all that apply. Primary DI is caused by a reduction in the secretion of antidiuretic hormone (ADH), which can result in an increased serum sodium. Can also result in fatigue due to electrolyte imbalance. Serum osmolality will be greater than 300 mOsm/L. A nurse is caring for a client who has DI. Which of the following urinalysis laboratory findings should the nurse anticipate? A decrease in serum sodium is caused by an increase in the secretion of ADH. A decrease in serum osmolarity is caused by an increase in the secretion of ADH. The nurse is assessing a client who has SIADH. Which of the following findings indicate the client is experiencing a complication? A. Decreased central venous pressure (CVP) Distended neck veins are a manifestation of fluid overload, which can lead to pulmonary edema and heart failure. Increased urine output is indicative of DI. A nurse is providing teaching to a client who has a new diagnosis of DI. Which of the following statements by the client requires further teaching? A. I can drink up to 2 quarts of fluid a day. B. I should expect to urinate frequently at night. Excessive thirst is a manifestation of DI. Consumption of 4 to 30 L per day can be expected, and fluid intake should not be limited. A nurse in a providers office is reviewing the health record of a client who is being evaluated for Graves' disease. Which of the following is an expected laboratory finding for this c Continue reading >>

Dka And Hhs Flashcards | Quizlet

Dka And Hhs Flashcards | Quizlet

Admin Rapid IV NS or 1/2 NS until HD stable (15-20 mL/kg/hr for 1st hr) (4-14 mL/kg/hr after bolus) Used to reverse ECF volume depletion - restore renal perfusion Average fluid loss for DKA: 6-10 L/24 hrs Fluids alone may initially decrease BG by 35-70 mg/dL When BG reaches 250 mg/dL, add D5W to IV fluids - prevents hypoglycemia Monitor for complications such as pulmonary or cerebral edema (occurs if serum osmolality decreases too rapidly) First Check potassium. If potassium is less than 3.3 mEq/L, delay insulin until K replacement. Admin IV infusion regular insulin @ 0.1 unit/kg/hr Do not decrease blood glucose by more than 75 mg/dL/hr. Decrease between 50-75/hr Avoid too rapid decrease in blood glucose to prevent cerebral edema and increased ICP. Titrate Q1H after checking blood glucose. K+ may be low, high, or normal -> EKG changes. Fluids and insulin can decrease potassium level. Before giving iV potassium, pt must produce urine @ least 30 mL/hr. Phosphate may be low, high or normal. RBC binds O2 more tightly if phosphate is low. Indication: pH < 7.0 and or Bicarb level < 5.0 mEq/L Causes life threatening hypokalemia if acidosis is corrected rapidly. Monitor respiratory status and admin oxygen as needed Monitor GI motility...may need NG for decompression Pt at risk..monitor peripheral circulation and administer prophylactic lovenox. Monitor blood glucose at least every 4 hours Test urine for ketones when blood glucose level is greater than 240 Continue to take insulin or oral antidiabetic agents To prevent dehydration, drink 8-12 ounces of sugar-free liquids every hour that you are awake. Continue to eat meals at regular times. If unable to tolerate solid food because of nausea, consume more easily tolerated foods or liquids equal to carb content of usual meal. Cal Continue reading >>

Diabetes- Ati Testing

Diabetes- Ati Testing

Sort What are the risk factors for DM? Genetics may predispose an individual to the occurrence of type 1 or type 2 diabetes. Toxins and viruses can predispose an individual to diabetes by destroying the beta cells leading to type 1 diabetes mellitus. Obesity, physical inactivity, high triglycerides (greater than 250 mg/dL), and hypertension may lead to the development of insulin resistance and type 2 diabetes. Secondary causes of diabetes include pancreatitis and Cushing's syndrome. What are the nutritional guidelines for patient's with DM to follow when sick? ■■ Monitor blood glucose every 3 to 4 hr. ■■ Continue to take insulin or oral antidiabetic agents. ■■ Consume 4 oz of sugar-free, non-caffeinated liquid every 0.5 hr to prevent dehydration. ■■Test urine for ketones and report to provider if they are abnormal (the level should be negative to small). Call the health care provider if: ■■ Blood glucose is greater than 240 mg/dL. ■■Fever is greater than 38.9° C (102° F), does not respond to acetaminophen, or lasts more than 12 hr. What patient education should be provided for S & S of hypoglycemia? ☐☐ Treat with 15 to 20 g carbohydrates Examples - 4 oz orange juice, 2 oz grape juice, 8 oz milk, glucose tablets per manufacturer's suggestion to equal 15 g ☐☐ Recheck blood glucose in 15 min. ☐☐ If still low (less than 70 mg/dL), give 15 to 20 g more of carbohydrates. ☐☐ Recheck blood glucose in 15 min. ☐☐ If blood glucose is within normal limits, take 7 g protein (if the next meal ismore than an hour away). Example - 1 oz of cheese (1 string cheese), 2 tablespoons of peanutbutter, or 8 oz of milk Oral hypoglycemics ■■ Alpha-Glucosidase Inhibitors - Acarbose (Precose) and miglitol (Glyset) ☐☐ Slows carbohydrate absorpti Continue reading >>

Nclex Style Practice Questions - Medsurg Diabetes

Nclex Style Practice Questions - Medsurg Diabetes

The guidelines for Carbohydrate Counting as medical nutrition therapy for diabetes mellitus includes all of the following EXCEPT: a. Flexibility in types and amounts of foods consumed b. Unlimited intake of total fat, saturated fat and cholesterol c. Including adequate servings of fruits, vegetables and the dairy group d. Applicable to with either Type 1 or Type 2 diabetes mellitus b. Unlimited intake of total fat, saturated fat and cholesterol The nurse working in the physician's office is reviewing lab results on the clients seen that day. One of the clients who has classic diabetic symptoms had an eight-hour fasting plasma glucose test done. The nurse realizes that diagnostic criteria developed by the American Diabetes Association for diabetes include classic diabetic symptoms plus which of the following fasting plasma glucose levels? When taking a health history, the nurse screens for manifestations suggestive of diabetes type I. Which of the following manifestations are considered the primary manifestations of diabetes type I and would be most suggestive of diabetes type I and require follow-up investigation? a. Excessive intake of calories, rapid weight gain, and difficulty losing weight b. Poor circulation, wound healing, and leg ulcers, c. Lack of energy, weight gain, and depression d. An increase in three areas: thirst, intake of fluids, and hunger D. An increase in three areas: thirst, intake of fluids, and hunger The primary manifestations of diabetes type I are polyuria (increased urine output), polydipsia (increased thirst), polyphagia (increased hunger). The nurse is working with an overweight client who has a high-stress job and smokes. This client has just received a diagnosis of Type II Diabetes and has just been started on an oral hypoglycemic agent. Continue reading >>

Diabetic Ketoacidosis And Patho

Diabetic Ketoacidosis And Patho

pathophysiology ketogenesis due to insulin deficiency leads to increased serum levels of ketones anad ketonuria acetoacetate, beta-hydroxybutyrate; ketone bodies produced by the liver, organic acids that cause metabolic acidosis respiration partially compensates; reduces pCO2, when pH < 7.2, deep rapid respirations (Kussmaul breathing) acetone; minor product of ketogenesis, can smell fruity on breath of ketoacidosis patients elevated anion gap Methanol intoxication Uremic acidosis Diabetic ketoacidosis Paraldehyde ingestions Intoxicants (salicyclate, ethylene glycol, nipride, epinephrine, norepinephrine) Lactic acidosis (drug induced; didanosine, iron, isoniazid, metformin, zidovudine) Ethanol ketoacidosis Severe renal failure starvation Blood glucose regulation (6) 1. When blood glucose levels rise above a set point, 2. the pancreas secretes insulin into the blood. 3. Insulin stimulates liver and muscle cells to make glycogen, dropping blood glucose levels. 4. When glucose levels drop below a set point, 5. the pancreas secretes glucagon into the blood. 6. Glucagon promotes the breakdown of glycogen and the release of glucose into the blood. (The pancreas signals distant cells to regulate levels in the blood = endocrine function.) Insulin and Glucagon (Regulation) (10) 1. High blood glucose 2. Beta cells 3. Insulin 4. Glucose enters cell 5. Blood glucose lowered 6. Low blood glucose 7. Alpha cells 8. Glucagon 9. Liver releases glucose from glycogen 10. Blood glucose raised What is the manifestations (symptoms) of Type 1? (10) 1. Extreme thirst 2. Frequent urination 3. Drowsiness, lethargy 4. Sugar in urine 5. Sudden vision change 6. Increased appetite 7. Sudden weight loss 8. Fruity, sweet, or wine like odor on breath 9. Heavy, laboured breathing 10. Stupor, unconscious Continue reading >>

Quizlet Endo | Adrenal Gland | Thyroid

Quizlet Endo | Adrenal Gland | Thyroid

1. are there increased decreased (increased uptake) 13. from where is chief cells in parathyroid gland or decreased amino parathyroid released? acids in the exactly what type of circulation with cells? increased insulin? 14. from where is prolactin adenohypophysis; increases 2. by what type of neuroendocrine cells; GI released? what effect dopamine synthesis and cells are carcinoid does it have on the secretion from the tumors caused by? hypothalamus? hypothalamaus (negative where are they feedback!) and decreased GnRH usually located? from hypothalamus 3. even though there is though there is a hyperkalemia due to 15. from where is hypothalamus; inhibition of Gh hyperkalemia in transcellular shift from acidosis, there somatostatin released? and TSH from adenohypophysis DKA there is a really is an intracellular depletion what does it result in? depleted because of the osmotic diuresis 16. from where is TRH hypothalamus; TSH and prolactin intracellular pulling potassium out (like sodium) released? what does it release from adenohypophysis potassium. explain. result in? 4. from what aa are tyrosine 17. how can you tell if a decreased uptake made? hyperthyroidism due to 5. from what cells is a parafollicular C cells exogenous thyroid ? medullary thyroid 18. how does a toxic hyperplasia causes gland carcinoma? multinodular goiter involution 6. from what precursor POMC; ACTH become nontoxic? is melanotropin 19. how does coma and d/t dehydration from diuresis made from? what death occur in DKA and acidosis precursor make? 20. how does hypercalcemia blocks NaCl reabsorption in the cause nephrogenic thick ascending limb disrupting 7. from where do the pancreatic buds; in the tail of the diabetes insipidus? counter current exchange and islets arise from? pancreas causing inabili Continue reading >>

Decreased Bowel Sounds & Diabetic Ketoacidosis & Embolic Mesenteric Infarction & Tachycardia: Causes & Reasons - Symptoma

Decreased Bowel Sounds & Diabetic Ketoacidosis & Embolic Mesenteric Infarction & Tachycardia: Causes & Reasons - Symptoma

Hypokalemia is common during the treatment of diabetic ketoacidosis (DKA); however, severe hypokalemia at presentation prior to insulin treatment is exceedingly uncommon. [ncbi.nlm.nih.gov] [] due to weakness of accessory muscle movement to breath) Confusion, weak Flaccid paralysis Decrease deep tendon reflexes Decreased bowel sounds Easy way to Remember 7 Ls Lethargy [registerednursern.com] A 38-year-old obese woman presented with recurrent polymorphic ventricular tachycardia secondary to persistent hypokalemia necessitating more than 40 DC shocks. [ncbi.nlm.nih.gov] Home Random Stuff Differences between Hyperosmolar Non-Ketotic Hyperglycaemic Coma and Diabetic Ketoacidosis Random Stuff 3,293 Views The differences between diabetic [howmed.net] , abdominal pain (ileus), gastric stasis, and leg cramps ketosis causes nausea and vomiting acidosis causes tachycardia, rapid deep breathing (Kussmaul), hypotension(vasodil [d3jonline.tripod.com] Volume depletion can lead to dry mucous membranes, tachycardia, and hypotension. Fever and abdominal tenderness may also be present. [accessmedicine.mhmedical.com] ketoacidosis; and myxedema. [patientcareonline.com] Additional symptoms that may accompany the condition are nausea, abdominal distention, vomiting, decreased bowel sounds, and also a mild level of tenderness over the abdomen [constipation-remedies.co.uk] Among its most deleterious effects are its ability to produce tachycardia, hypertension, and ischemia. [ncbi.nlm.nih.gov] Diabetic ketoacidosis is an acute, often life-threatening complication of diabetes which is mainly seen in individuals with the type 1 diabetes. [symptoma.com] Abstract Ventricular tachycardia is uncommon in children without CHD. [ncbi.nlm.nih.gov] Supraventricular tachycardia (SVT), however, is a very r Continue reading >>

Chest Pain | Receiving.

Chest Pain | Receiving.

1) C Pneumomediastinum. You can see air tracking in the soft tissues of the neck and the upper aspects of the mediastinum. Although there could potentially be a pneumothorax (B) associated with this this, no pneumothorax can be seen in this study. No foreign body (A) is present and there is no infiltrate to suggest pneumonia (D). 2) A Alveolar rupture secondary to forceful retching is the most likely etiology of the pneumomediastinum, although you should also be concerned for possible esophageal rupture secondary to forceful wretching (B) also known as Boerhaaves esophagus. Review of the literature shows that in similar presentations, esophograms are typically negative for tears in the esophagus. Acute PE (C) has not been shown to present with free air. On a chest xray, the most concerning (and classically pimped) findings for acute PE are Hamptons Hump and Westermarks sign. Hamptons Hump, represented in the first image below, shows a wedge shaped area of hyperdensity along the lung parenchyma periphery, indicative of an infact/PE. Westermarks sign, as shown in the second image below, shows a focal peripheral hyperlucency secondary to oligemia, with or without dilation of the central pulmonary vessels. 3) B Although there is no obvious pneumothorax on the initial chest x ray, you must keep a high level of suspicion for a small pneumothorax. This would not necessitate chest tube placement (A), but a nonrebreather and continuous pulse oximetry are appropriate if a small pneumothorax is present. Given that the retching led to the pneumomediastinum, treat her nausea with ondansetron. She should be kept NPO until an esophagram can be obtained (as an inpatient or in the observation unit) to definitively rule out Boerhaaves esophagus. As an inpatient, the chest x ray should r Continue reading >>

Diabetes Insipidus

Diabetes Insipidus

What are the types of diabetes insipidus? Central Diabetes Insipidus The most common form of serious diabetes insipidus, central diabetes insipidus, results from damage to the pituitary gland, which disrupts the normal storage and release of ADH. Damage to the pituitary gland can be caused by different diseases as well as by head injuries, neurosurgery, or genetic disorders. To treat the ADH deficiency that results from any kind of damage to the hypothalamus or pituitary, a synthetic hormone called desmopressin can be taken by an injection, a nasal spray, or a pill. While taking desmopressin, a person should drink fluids only when thirsty and not at other times. The drug prevents water excretion, and water can build up now that the kidneys are making less urine and are less responsive to changes in body fluids. Nephrogenic Diabetes Insipidus Nephrogenic diabetes insipidus results when the kidneys are unable to respond to ADH. The kidneys' ability to respond to ADH can be impaired by drugs-like lithium, for example-and by chronic disorders including polycystic kidney disease, sickle cell disease, kidney failure, partial blockage of the ureters, and inherited genetic disorders. Sometimes the cause of nephrogenic diabetes insipidus is never discovered. Desmopressin will not work for this form of diabetes insipidus. Instead, a person with nephrogenic diabetes insipidus may be given hydrochlorothiazide (HCTZ) or indomethacin. HCTZ is sometimes combined with another drug called amiloride. The combination of HCTZ and amiloride is sold under the brand name Moduretic. Again, with this combination of drugs, one should drink fluids only when thirsty and not at other times. Dipsogenic Diabetes insipidus Dipsogenic diabetes insipidus is caused by a defect in or damage to the thirst Continue reading >>

Jay Cutler Diabetes Treatment

Jay Cutler Diabetes Treatment

This opening sequence discusses the unique response to selective PPAR modulators and the resulting activation or repression of different genes that lead to distinct biological It chops everything!! It has always chopped my frozen fruit very well and it will chop what causes hyperglycemia in type 2 diabetes mellitus raw carrots and celery within my same smoothy perfectly!! I was super impressed by those 2 veggies(perfect in smoothies for added nutrients and diabetic ulcer honey you barely taste them..perfect for kids to get their veggies in..oh so sneaky)! Carrots are very hard and it blends them right up! And celery..it chops all the stringy stuff..so you are left with no strings..all you see are tiny specks of green throughout your smoothy! Just awesome!! This is with the larger 4 sample diabetic meal plan 2000 calories blade top. dependent diabetes multiple daily insulin injections association uk insulin dependent diabetes type 2 diabetes insulin resistance metabolic syndrome i want insulin 100iu/ml online tab fedex sample meal plan for gestational diabetes insulin resistance diabetes sleepiness insulin Jay Cutler Diabetes Treatment resistance high insulin Pre-diabetes does not have to result in diabetes if lifestyle changes are made. Jay Cutler Diabetes Treatment learn about the insulin pump for diabetes. I got this book and I have actually read a good portion of it.. symptoms of diabetes legs diabetes treatment in urdu diabetes neuropathy treatment sugar diabetes high levels diabetes nutrition education spanish Got this product for the tinnitus & have noticed very little change in the tinitus. Continuous Glucose Monitoring. Know more about this condition. gestational diabetes symptoms diagnosis la diabetes tipo 2 cuales organos afecta Find a Provider * Required * G Continue reading >>

Medconversations On Apple Podcasts

Medconversations On Apple Podcasts

Glomerulonephritis Part 2 Nephritic Syndromes Glomerulonephritis Part 2 Nephritic Syndromes If you naively thought that part 2 of glomerulonephritis would never come and you could spend the rest of your summer wallowing in glorious ignorance of those confusing glomerulonephritidis then you were wrong. Here are the rest of the nephritic Continue reading Davors back doing his Davor thing and sprucing neurology to the world (whether they want to hear about it or not). So, if the holiday blues have you feeling numb to the world or passion for the new year has Continue reading Has your troubled history of pot plant homicide led to legal action over your plant carer registration AND/OR your grandmother giving up on you and gifting all her cuttings to her previously second favourite grandchild? We cant help you with Continue reading Dust off your ear horn, ruffle up your ruffles and prepare your first-born son for a painful but career-favouring transition. Bec and Scott are back and hitting every high note as they croon, roar and trill their way through hypercalcaemia Glomerulonephritis Part 1 Nephrotic Syndromes Glomerulonephritis Part 1 Nephrotic Syndromes Get your amphora ready to catch some of the golden stuff and see if you have the blood and the protein to raise some nephrologist eyebrows. Weve heard the requests of the people and taken on GN in an epic Continue reading Think you might have what it takes to join the extraordinary league of gentle-people against epilepsy? Well youll need some training first. Come join Davor and Rahul for a shake-down of the epilepsy world. P.S. I tried my best to Continue reading Continue reading >>

Dka/hhns

Dka/hhns

Sort Metabolic acidosis HCO3 <22 pH <7.35 paCO2 normal (uncompensated) paCO2 <35 (partially compensated) pH 7.35-7.39 (acidic normal) & paCO2 <35 (fully compensated) "If ill, take your insulin and drink clear liquids with carbohydrate." The client must be familiar with "sick day" management. He should take his insulin, check his blood glucose every 1 to 4 hr, and if unable to eat solid food, take in small frequent amounts of fluids and glucose-containing beverages. Which of the following is an appropriate client instruction regarding DKA prevention? Abdominal pain The client with HHNS would not have abdominal pain, a symptom of acidosis. Confusion from dehydration would be present, as would thirst and frequent urination. Which of the following signs and symptoms is least likely in HHNS? Metabolic acidosis secondary to breakdown of fats for energy manifested by ketosis is most likely. Rapid, deep respirations (Kussmaul's respirations) will show compensation for the acidosis as the body "blows off" carbon dioxide, a respiratory acid. What type of acid-base imbalance is likely in a client with DKA? How would the nurse recognize compensation for this acid-base disorder? Physical and/or psychological stress stimulates the sympathetic nervous system's fight or flight response. This results in an increased production of catecholamines (epinephrine and norepinephrine), which stimulate the release of cortisol. This results in glycolysis, the breakdown of glycogen into glucose. What is the relationship between stress and blood glucose levels in a client with diabetes? The nurse's first action should be to assess whether the client is adherent to the currently prescribed diet and medications. The client's current diet and medication use have not been successful in keeping 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 >>

Symptoms Diabetes Type 2 Feet Are Quizlet Classic What Type 1 Child Mellitus Symptoms

Symptoms Diabetes Type 2 Feet Are Quizlet Classic What Type 1 Child Mellitus Symptoms

Pregnancy & Prenatal Testing Symptoms Diabetes Type 2 Feet Are Quizlet Classic What Type 1 Child Mellitus Symptoms In order to control gestational diabetes you must add simple carbohydrates in your daily intake. This week: dealing with diabetes at Christmas. DFYI-Looking for a Hip Modern Diabetic Carrying Case? Look no further. Some types of illness can affect your diabetes control by raising your blood glucose levels. Spices and Herbs: Unexpected Sources of Antioxidants. Family history is the number-one risk factor for type-2 diabetes and obesity is a strong second risk factor. Symptoms of diabetic ketoacidosis are If your diabetes cant be controlled with diet exercise and Food For Diabetics To Eat: Diet is a big part of it as well as exercise parboiled rice and diabetes sugar too is high when blood exercise When youre not pregnant your bladder can hold up to a pint of urine Cancer Diagnosis; Cancer and Nutrition; la protena que haya en la orina puede significar una afeccin muy peligrosa llamada preeclampsia Qu glucose meter walmart food diet much gestational too es la diabetes tipo 2? Tiene diabetes? Anemia y la enfermedad renal Guideline coordinator: Avra Cohen MN Clinical Improvement & Prevention cohen Effective management of Type 2 diabetes usually requires a multi-pronged approach that includes drug therapies and lifestyle changes Professional and Career Resources > Nutrition Education > Sources of Free or Low-Cost Materials > Nutrition Juvenile Diabetes Research Foundation International Internationally agreed criteria are highly desirable to define standards and goals and to enable References . Effects of exercise on glucose homeostasis in Type 2 diabetes mellitus. You can also roll the cookies in the sugar sprinkles before baking. While the clearance rate of cr Continue reading >>

Diabetes Nclex Questions

Diabetes Nclex Questions

1, 4, 6 Rationale: Classic signs of diabetes mellitus include polydipsia (excessive thirst), polyphagia (excessive hunger), and polyuria (excessive urination). Because the body is starving from the lack of glucose the cells are using for energy, the client has weight loss, not weight gain. Clients with diabetes mellitus usually don't present with constipation. Urine retention is only a problem is the patient has another renal-related condition. A client is brought to the emergency department in an unresponsive state, and a diagnosis of hyperglycemic hyperosmolar nonketotic syndrome is made. The nurse would immediately prepare to initiate which of the following anticipated physician's prescriptions? 1. Endotracheal intubation 2. 100 units of NPH insulin 3. Intravenous infusion of normal saline 4. Intravenous infusion of sodium bicarbonate CORRECT ANSWER: 3. Intravenous infusion of normal saline Rationale: The primary goal of treatment is hyperglycemic hyperosmolar nonketotic syndrome (HHNS) is to rehydrate the client to restore the fluid volume and to correct electrolyte deficiency. Intravenous fluid replacement is similar to that administered in diabetic keto acidosis (DKA) and begins with IV infusion of normal saline. Regular insulin, not NPH insulin, would be administered. The use of sodium bicarbonate to correct acidosis is avoided because it can precipitate a further drop in serum potassium levels. Intubation and mechanical ventilation are not required to treat HHNS. "A client is taking Humulin NPH insulin daily every morning. The nurse instructs the client that the mostlikely time for a hypoglycemic reaction to occur is: B: Rationale: Humulin is an intermediate acting insulin. The onset of action is 1.5 hours, it peaks in 4-12 hours, and its duration is 24 hours. Continue reading >>

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