A patient has been admitted with diabetic ketoacidosis. The ...

[cdr_15]

A patient has been admitted with diabetic ketoacidosis. The emergency department starts an IV to improve circulatory volume.
 
  If there is a sudden change in extracellular fluid osmolality that results in a too rapid blood glucose lowering, the nurse will likely observe which of the following clinical manifestations?
  A)
  Chills, profuse sweating, weakness
  B)
  Headaches, dizziness, change in level of consciousness
  C)
  Increase urine output, thirst, vomiting
  D)
  Rapid, deep respirations, palpitations, low BP

Question 2

A 24-year-old woman undergoing a premarital screening test is found to have elevated levels of AST, ALT, and IgG, but no antibody-specific markers for viral hepatitis. A liver biopsy reveals inflammation and cellular damage.
 
  Which of the following treatments is most likely to be effective for her?
  A)
  Lamivudine
  B)
  Peginterferon and ribavirin
  C)
  Interferon alfa-2b
  D)
  Corticosteroids and immunosuppressant drugs

[SomethingSomething]

Answer to Question 1

Ans:
B

Feedback:

A sudden change in the osmolality of extracellular fluid can also occur when blood glucose levels are lowered too rapidly, and this can cause cerebral edema, more common in children than in adults. Answers A, B, and C all have some component of signs and symptoms of DKA rather than cerebral edema signs and symptoms (answer B).

Answer to Question 2

Ans:
D

Feedback:

This woman's hepatitis is probably caused by an autoimmune disorder rather than a virus. Lamivudine, peginterferon/ribavirin, and interferon alfa-2b are all antiviral agents. Autoimmune hepatitis is a chronic, usually progressive, inflammatory disease of the liver. Corticosteroids are the mainstay of treatment and have been shown to produce remission. Azathioprine, an immunosuppressant medication, is sometimes used along with prednisone. Using both medications may allow you to take a smaller dose of prednisone, reducing its side effects. Most people with this disease require long-term maintenance treatment.