A 27-year-old patient admitted with diabetic ketoacidosis (DKA) ...

[V@ndy87]

A 27-year-old patient admitted with diabetic ketoacidosis (DKA) has a serum glucose level of 732 mg/dL and serum potassium level of 3.1 mEq/L. Which action prescribed by the health care provider should the nurse take first?
 
  a. Place the patient on a cardiac monitor.
  b. Administer IV potassium supplements.
  c. Obtain urine glucose and ketone levels.
  d. Start an insulin infusion at 0.1 units/kg/hr.

Question 2

A 54-year-old patient is admitted with diabetic ketoacidosis. Which admission order should the nurse implement first?
 
  a. Infuse 1 liter of normal saline per hour.
  b. Give sodium bicarbonate 50 mEq IV push.
  c. Administer regular insulin 10 U by IV push.
  d. Start a regular insulin infusion at 0.1 units/kg/hr.

[okolip]

Answer to Question 1

ANS: A
Hypokalemia can lead to potentially fatal dysrhythmias such as ventricular tachycardia and ventricular fibrillation, which would be detected with electrocardiogram (ECG) monitoring. Because potassium must be infused over at least 1 hour, the nurse should initiate cardiac monitoring before infusion of potassium. Insulin should not be administered without cardiac monitoring because insulin infusion will further decrease potassium levels. Urine glucose and ketone levels are not urgently needed to manage the patient's care.

Answer to Question 2

ANS: A
The most urgent patient problem is the hypovolemia associated with diabetic ketoacidosis (DKA), and the priority is to infuse IV fluids. The other actions can be done after the infusion of normal saline is initiated.

[V@ndy87]

Excellent

[nathang24]

Gracias!