A patient was admitted with diabetic ketoacidosis 1 hour ago and ...

[Mr.Thesaxman]

A patient was admitted with diabetic ketoacidosis 1 hour ago and is on an insulin drip. Suddenly, the nurse notices frequent premature ventricular contractions (PVCs) on the electrocardiogram. The expected intervention would be to
 
  a. administer a lidocaine bolus.
  b. administer a lidocaine drip.
  c. synchronize cardioversion.
  d. evaluate electrolytes.

Question 2

The primary mechanism in the development of tumor lysis syndrome is
 
  a. destruction of platelets by lymphocytic antibodies.
  b. destruction of malignant cells through radiation or chemotherapy.
  c. formation of heparin antibodies.
  d. damage to the endothelium.

[Pamela.irrgang@yahoo.com]

Answer to Question 1

D
Hyperkalemia occurs with acidosis or with overaggressive administration of potassium replacement in patients with renal insufficiency. Severe hyperkalemia is demonstrated on the cardiac monitor by a large, peaked T wave; flattened P wave; and widened QRS complex.

Answer to Question 2

B
The primary mechanism involved in the development of tumor lysis syndrome is the destruction of massive numbers of malignant cells, either by chemotherapy or radiation. This mass destruction results in the release of large amounts of potassium, phosphorus, and nucleic acids, leading to severe metabolic disturbances such as hyperuricemia, hyperkalemia, hyperphosphatemia, and hypocalcemia.

[Mr.Thesaxman]

Gracias!

[Alyson.hiatt@yahoo.com]

Excellent