Medsurg final 5

Question 1

DKA or HHS: Polyuria

Answer 1

both

Question 2

DKA or HHS: Polydipsia

Answer 2

both

Question 3

DKA or HHS: Polyphagia

Answer 3

DKA

Question 4

DKA or HHS: Weight loss

Answer 4

DKA

Question 5

DKA or HHS: GI effects (nausea, vomiting, abdominal pain)

Answer 5

DKA

Question 6

DKA or HHS: Blurred vision, headache, weakness

Answer 6

both

Question 7

DKA or HHS: Orthostatic hypotension

Answer 7

both

Question 8

DKA or HHS: Fruity odor of breath

Answer 8

DKA

Question 9

DKA or HHS: Kussmaul respirations

Answer 9

DKA

Question 10

DKA or HHS: Metabolic acidosis

Answer 10

DKA

Question 11

DKA or HHS: Mental status changes

Answer 11

Both

Question 12

DKA or HHS: Seizures, myoclonic jerking

Answer 12

HHS

Question 13

DKA or HHS: Reversible paralysis

Answer 13

HHS

Question 14

Cause of DKA manifestation: Cells are unable to use glucose because of insulin deficiency. The body is placed in a catabolic state.

Answer 14

Weight loss

Question 15

Cause of DKA manifestation: the breakdown of stored glucose, protein, and fat to produce ketone bodies

Answer 15

Metabolic acidosis

Question 16

Cause of HHS manifestation: Related to serum osmolarity greater than 350 mOsm/L

Answer 16

Seizures and Paralysis

Question 17

tx of DM complications: maintain perfusion to vital organs by

Answer 17

giving rapid isotonic fluid (NS) replacement

Question 18

tx of DM complications: When serum glucose levels approach 250 mg/dL, add ____ to IV fluids to minimize the risk of cerebral edema associated with drastic changes in serum osmolarity and prevent hypoglycemia

Answer 18

glucose

Question 19

tx of DM complications: When serum glucose levels approach 250 mg/dL, add glucose to IV fluids to minimize the risk of cerebral edema associated with

Answer 19

drastic changes in serum osmolarity and prevent hypoglycemia

Question 20

tx of DM complications: Administer regular insulin (Humulin R) 0.1 unit/kg as an IV bolus dose and then follow with a

Answer 20

continuous IV infusion of regular insulin at 0.1 unit/kg/hr.

Question 21

tx of DM complications: Blood glucose of less than ___ mg/dL is the goal for resolution

Answer 21

200

Question 22

tx of DM complications: monitor for what electrolyte

Answer 22

K

Question 23

What electrolyte levels will initially be increased with insulin therapy

Answer 23

K

Question 24

Potassium levels will initially be increased with insulin therapy, but

Answer 24

potassium will shift into cells and the client will need to be monitored for hypokalemia.

Question 25

with insulin therapy, what are you ultimately monitoring for, hypo or hyper kalemia

Answer 25

hypo (K moves into the cells)

Question 26

Make sure ___ ___ is adequate before administering potassium

Answer 26

urinary output

Question 27

tx of DM complications: Administer ___ ____ by slow IV infusion for severe acidosis (pH of less than 7.0)

Answer 27

sodium bicarbonate

Question 28

tx of DM complications: Administer sodium bicarbonate by slow IV infusion for

Answer 28

severe acidosis (pH of less than 7.0)

Question 29

correcting acidosis too quickly may lead to

Answer 29

hypokalemia

Question 30

Emphasize the importance of not skipping __ __ when ill

Answer 30

insulin dose

Question 31

tx of DM complications: Consume liquids with carbohydrates and ____ (____) when unable to eat solid food.

Answer 31

electrolytes (gatorade)

Question 32

Notify the provider if: Ketones are found in urine for more than

Answer 32

24 hr