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Lewis's Medical Surgical Nursing 11th Edition Harding Test Bank questions and detailed answers
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Lewis's Medical SurgicalNursing 11th Edition Harding
Test Bank questions and
detailed answers
A 26-yr-old female who has type 1 diabetes
develops a sore throat and runny nose after
caring
for her sick toddler. The patient calls the clinic
for advice about her symptoms and reports a
blood glucose level of 210 mg/dL despite taking
her usual glargine (Lantus) and lispro
(Humalog) insulin. What should the nurse
advise the patient to do?
,a. Use only the lispro insulin until the
symptoms are resolved.
b. Limit intake of calories until the glucose is
less than 120 mg/dL.
c. Monitor blood glucose every 4 hours and
contact the clinic if it rises.
d. Decrease carbohydrates until glycosylated
hemoglobin is less than 7%. - answer ✅✅ANS:
C
Infection and other stressors increase blood
glucose levels and the patient will need to test
blood glucose frequently, treat elevations
appropriately with lispro insulin, and call the
health
care provider if glucose levels continue to be
elevated. Discontinuing the glargine will
contribute to hyperglycemia and may lead to
diabetic ketoacidosis (DKA). Decreasing
carbohydrate or caloric intake is not
appropriate because the patient will need more
calories
,when ill. Glycosylated hemoglobin testing is not
used to evaluate short-term alterations in
blood glucose.
DIF: Cognitive Level: Apply (application)
TOP: Nursing Process: Implementation MSC:
NCLEX: Physiological Integrity
A 27-yr-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. Ask the patient about home insulin doses.
d. Start an insulin infusion at 0.1 units/kg/hr.
- answer ✅✅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. Discussion
of
home insulin and possible causes can wait
until the patient is stabilized.
DIF: Cognitive Level: Analyze (analysis)
OBJ: Special Questions: Prioritization TOP:
Nursing Process: Implementation
MSC: NCLEX: Physiological Integrity
A 28-yr-old male patient with type 1 diabetes
reports how he manages his exercise and
glucose control. Which behavior indicates that
the nurse should implement additional
teaching?
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