ATI Med-Surg PRACTICE A 2019

ATI Med-Surg PRACTICE A 2019 A nurse is reviewing laboratory values for a client who has diabetic ketoacidosis (DKA). Which of the following results should the nurse expect? Negative urine ketones BUN 32 mg/dL pH 7.43 HCO3- 23 mEq/L - ANSWER BUN 32 mg/dL DKA results in osmotic diuresis and subsequent dehydration. The nurse should expect a client who has DKA to have elevated BUN, creatinine, and specific gravity levels resulting from the excess glucose present in the urine. A client who has DKA experiences ketosis, which results in ketones in the urine and blood. The nurse should expect a client who has DKA to have a pH level less than 7.35 due to the increased production of ketones, which results in metabolic acidosis. The client might exhibit Kussmaul respirations, which are deep and rapid respirations that compensate for the decreased pH. Sodium bicarbonate is administered for severe acidosis when the client's pH level is less than 7. The nurse should expect a client who has DKA to have an HCO3- less than 15 mEq/L. This decreased value is due to an increased production of ketones, resulting in metabolic acidosis. A nurse and an assistive personnel (AP) are caring for a client who has bacterial meningitis. The nurse should give the AP which of the following instructions? Wear a Mask. Droplet Precautions Wear a gown. Keep the client's room well-lit. Maintain the head of the bed at a 45° elevation. - ANSWER Wear a Mask. Droplet Precautions A gown is necessary when caring for clients who require contact precautions. Bacterial meningitis does not spread via direct contact. Staff caring for this client should keep the illumination in the room dim and avoid bright light from windows to promote comfort and rest and avoid photophobia. Staff caring for this client should keep the head of the bed at a 30° elevation.