Endocrine

What clinical manifestations does the nurse recognize would be associated with a diagnosis of hyperthyroidism? (Select all that apply.) a) An elevated systolic blood pressure b) Weight loss. c) Muscular fatigability d) A pulse rate slower than 90 bpm e) Intolerance to cold

A) an elevated systolic blood pressure B) weight loss C) muscular fatigability

A nurse is reviewing the health record of a client who has HHS. which of the following data confirms the diagnosis? (select all that apply) A. evidence of recent MI B. BUN 35 mg/dL C. Takes a calcium channel blocker D. age 77 E. no insulin production

A,B,C,D The client who has type 2 diabetes and had an MI is at risk for developing HHS. this is due to the increased hormone production during illness or stress, which can stimulate the liver to produce glucose and decrease the effects of insulin. also when the BUN is increased kidney function is decreased and the kidneys are unable to filter out glucose.

A nurse is providing discharge teaching to a client who experienced DKA. which of the following should the nurse include in the teaching? (sata) A. Drink 3 L of fluids daily B. Monitor BGL every 4 hr when ill C. administer insulin as prescribed when ill D. notify the provider when BGL is 200 E. report ketones in the urine after 24 hr of illness

A,B,C,E

A nurse is presenting info to a group about nutrition habits that prevent type 2 diabetes. which of the following should the nurse include in the information? (select all that apply) A. eat less meat and processed foods B. decrease intake of saturated fats C. increase daily fiber intake D. limit saturated fat intake to 15% of daily caloric intake E. include omega-3 fatty acids in the diet

A,B,C,E the recommended fat intake is no more than 7%

A nurse in a provider's office is planning care for a client who has a new diagnosis of Graves' disease and a new prescription for methimazole (tapazole). Which of the following should the nurse include in the plan of care? (select all that apply) A. Monitor CBC B. monitor T3 C. inform the client that the medication should not be taken for more than 3 months D. Advise the client to take meds at the same time everyday E. inform the client that an adverse effect of this med is iodine toxicity

A,B,D tapazole can be taken for 1-2 years

A nurse is preparing to receive a client from the PACU who is postoperative following a thyroidectomy. the nurse should ensure that which of the following equipment is available? (select all that apply) A. suction equipment B. humidified air C. Flashlight D. tracheostomy car E. Oxygen delivery equipment

A,B,D,E

Which of the following is an age-related change that may affect diabetes? Select all that apply A. Decreased renal function B. decreased vision C. increased proprioception D. taste changes E. increased bowel motility

A. Decreased renal function B. Decreased vision C. Taste changes

A nurse is monitoring a client's status 24 hr after a total thyroidectomy. Which of the following findings should the nurse report to the provider? A. Layrngeal stridor B. productive cough C. pain with hyperextension of the neck D. Hoarse, weak voice

A. Laryngeal Stridor laryngeal stridor is a harsh, high-pitched sound upon inspiration that indicated respiratory obstruction. the nurse should take immediate action to preserve the client's airway

a nurse is reviewing the lab findings of a client who has suspected hyperthyroidism. An elevation of which of the following supports this diagnosis? A. Triiodothyronine (T3) B. Vanillymandelic (VMA) C. Adrenocorticotropic hormone (ACTH) D. Glycosylated hemoglobin (HbA1c)

A. T3 increases a hyperthyroid state VMA is for pheochromocytoma and relfects the amount of catecholamin byproducts, ACTH is to detect cushing's

A nurse is providing teaching to a client who has a new diagnosis of diabetes insipidus. Which of the following statements by the client requires further teaching? A. "I can drink up to 2 quarts of fluid daily" B. "I should expect to urinate frequently at night" C. "I may experience headaches" D. "I may experience dry mouth"

A. excessive thirst is a manifestation of DI. consumption of 4 to 30L/day can be expected and fluid intake should not be limited

A nurse is preparing to administer propanolol by IV bolus to a client experiencing a thyroid storm. which of the following findings indicates the client is having a therapeutic response? A. reduction of the effects of thyroid hormone on the heart B. blockage of the release of thyroid hormone from the thyroid gland C. increase of the heart's sensitivity to thyroid hormone D. increase of the uptake of thyroid hormone by the thyroid gland

A. reduction of the effects of thyroid hormone on the heart

A client who was diagnosed with type 1 diabetes 14 years ago is admitted to the medical-surgical unit with abdominal pain. On admission, the client's blood glucose level is 470 mg/dl. Which finding is most likely to accompany this blood glucose level? a) Arm and leg trembling b) Rapid, thready pulse c) Cool, moist skin d) Slow, shallow respirations

B) rapid, thready pulse

A nurse is assessing a client who has diabetic ketoacidosis and ketones in the urine. Which of the following are expected findings? (sata) A. weight gain B. fruity odor of breath C. abdominal pain D. kussmaul respirations E. metabolic acidosis

B,C,D,E

A nurse is teaching a client about glycosylated hemoglobin (HbA1c) testing. Which of the following statements from the client indicates an understanding of the information about this test? A. "I need to fast after midnight the night before the test" B. "this test is a good indicator if my average blood glucose levels." C. "A level of 8-10% suggest adequate blood glucose control" D. " I will use my HbA1c level to adjust my daily insulin doses"

B. HbA1c reflects the client's glucose levels over a 12-day period, which is the lifespan of RBCs.

A nurse is assessing a client who has diabetes insipidus. The nurse should expect which of the following findings? A. Decreased heart Rate B. Increased hematocrit C. High urine specific Gravity D. Decreased BUN

B. Increased hematocrit An increased hematocrit level is an expected finding related to degydrtaion increased urine output leads to dilute urine and a LOW urine specific gravity Tachycardia is an expected finding of diabetes insipidus Increased in BUN relates to dehydration

A nurse is teaching a patient with hyperparathyroidism how to prevent hypercalcemia. The nurse should include which of the following in her medical counseling? A. drink 4 glasses of milk per day B. get regular, weight bearing exercise C. increase fluid intake to 3000mL/day D. reduce calcium intake

B. Weight bearing exercise, such as walking or running, prevents the breakdown of bones and release of calcium into bloodstream. frequent stimulation of osteoblast activity is needed.

A nurse is a provider's office is reviewing the health record of a client who is being evaluated for Grave's disease. Which of the following is an expected laboratory finding for this client? A. decreased thyrotropin receptor antibodies B. decreased thyroid stimulating hormone C. decreased free thyroxine index D. decreased triiodothyronine

B. decreased TSH

Dilutional hyponatremia occurs in which disorder? a) Addison's disease b) Pheochromocytoma c) Syndrome of inappropriate antidiuretic hormone secretion (SIADH) d) (Diabetes insipidus) DI

C) SIADH

A nurse is teaching foot care to a client who has diabetes mellitus. Which of the following info should the nurse include in the teaching? (select all that apply) A. remove calluses using OTC remedies B. apply lotion between toes C. perform nail care after bathing D. trim toenails straight across E. wear closed-toed shoes

C,D,E

A nurse in a provider's office is reviewing the lab findings of a client who is being evaluated for primary hypothyroidism. Which of the following lab findings is expected? A. serum T4 10 mcg/dL B. Serum T3 200 ng/dL C. Hematocrit 34% D. Serum cholesterol 180 mg/dL

C. HCT 34% this indicates anemia, which is an expected result of hypothyroidism

A nurse is assessing a client who has a new diagnosis of Cushing's disease. Which of the following findings should the nurse expect? A. decreased BP B. weight loss C. Hirsutism D. increased skin thickness

C. Hirsutism is an expected finding of Cushing's

The nurse assess a patient who has an obvious goiter. What type of deficiency does the nurse recognize is most likely the cause of this? a) Thyrotropin b) Calcitonin c) Iodine d) Thyroxine

C. Iodine Oversecretion of thyroid hormones is usually associated with an enlarged thyroid gland known as a goiter. Goiter also commonly occurs with iodine deficiency

A nurse is admitting a client who has hyperthyroidism. When assessing the client, the nurse should expect which of the following findings? A. cold intolerance B. lethargy C. tremors D. sunken eyes

C. Tremors - findings of hyperthyroidism include tremors, diaphoresis, and insomnia

A nurse is preparing to administer the morning dose of glargine (lantus) insulin and regular (humulin R) insulin to a client who has a BGL of 278. which of the following is an appropriate action by the nurse? A. draw up the regular insulin and then the glargine insulin in the same syringe B. draw up the glargine insulin then the regular insulin in the same syringe C. draw up and administer regular and glargine insulin in separate syringes D. administer the regular insulin, wait 1 hr, the administer glargine

C. administer each insulin as a separate injection. These insulins are not compatible

A patient with diabetes mellitus is prescribed to switch from animal to synthesized human insulin. Which of the following factors should the nurse monitor when caring for the patient? a) Allergic reactions b) Hypertonicity c) Polyuria d) Low blood glucose levels

D) low BGLs human insulin is more effective

A nurse is providing teaching for a client with Diabetes Mellitus. Which of the following findings associated with DKA should the nurse include? A. decreased urine output B. weight gain of 1lb in 24 hr C. rapid, shallow respirations D. BGL greater than 300 mg/dL

D. BGL > 300 Deep kussmaul respirations are expected with DKA

A nurse is reviewing lab reports of a client who has HHS. which of the following is an expected finding? A. serum pH 7.2 B. serum osmo 350 C. serum potassium 3.8 D. serum creatinine 0.8

B HHS would have a serum osmo greater than 320

A nurse is caring for a 69 yo male with hyperthyroidism. To provide additional comfort for the patient, the nurse should do which of the following interventions? A. Administer a stool softener B. apply warm packs to the patient's forehead C. Offer the patient coffee or tea D. provide a cool environment

D

A nurse is providing instructions to a client who has Graves' disease and has a new prescription for propanolol(inderal). Which of the following information should the nurse include? A. an adverse effect of this medication is jaundice B. take your pulse before each dose C. the purpose of this medication is to decrease production of thyroid hormone D. you should stop taking this med if you have a sore throat

B. check pulse Propanolol can cause bradycardia.

Margaret, a 52 yo grocery clerk, has been experience a decrease in serum calcium. She has undergone diagnostics, and her physician proposes her calcium fluctuation is due to altered parathyroid hormone function. What is the role of Parathormone? A. inhibits release of calcium into extracellular fluid B. increases serum calcium level C. promotes urinary secretion of calcium D. decreases serum calcium level

B. increases serum calcium level

A nurse is planning preoperative care for a client who has pheochromocytoma. Which of the following interventions should the nurse anticipate as being priority? A. use the same arm for BP measurement B. Avoid palpating the abdomen C. Manage headaches with analgesics D. Provide a private, darkened room.

B. the greatest risk for this client is injury from hypertensive crisis. therefore, the priority intervention is to avoid palpating the abdomen, which can cause a sudden release of catecholamines, causing a hypertensive crisis.

A patient receives a daily injection of glargine(lantus) insulin at 7:00a,m. When should the nurse monitor the patient for a hypoglycemic reaction? a) Between 4:00 and 6:00 PM b) Between 8:00 and 10:00 AM c) Between 7:00 and 9:00 PM d) D This insulin has no peak action and does not cause a hypoglycemic reaction.

D. this insulin has no peak action and does not cause a hypoglycemic reaction Peakless basal or very long-acting insulins are approved by the FDA for use as basal insulin. the insulin is absorbed very slowly over 24 hours and can be given once a day.

Which medication is the treatment of choice for a patient with hyperthyroidism who becomes pregnant? Methimazole (MMI) Propylthiouracil (PTU)

PTU

Which type of cell secretes glucagon and promotes gluconeogenesis? a) Alpha b) Beta c) Omega d) Delta

A) Alpha

A nurse in an ICU is admitting a client who has myxedema coma. Which of the following should the nurse anticipate in caring for this client? (select all that apply) A. observe cardiac monitor for inverted T wave B. observe for evidence of urinary tract infection C. initiate IV fluids using 0.9& nacl D. expect a prescription of levothyroxine IV bolus E. provide warmth using a heating pad

A,B,C,D Myxedema may have flat or inverted T wave as well as ST deviations an infection may precipitate a myxedema coma, hyponatremia is a typical finding, dont use electric heating

A nurse is caring for a client with primary Diabetes insipidus. Which of the following manifestations should the nurse expect to find? (select all that apply) A. serum sodium of 155 mEq/L B. fatigue C. Serum osmolality of 250 mOsm/L D. Polyuria E. Nocturia

A,B,D,E primary diabetes insipidus is caused by a reduction of ADH, which can result in increased serum sodium, fatigue due to electrolyte imbalance, polyuria, and nocturia

A client is admitted into the ICU in DKA. Which interventions are used to manage acidosis? (sata) A. add potassium to replacement fluid therapy B. administer insulin IV C. administer insulin subq as ordered D. administer sodium bicarb E. rapidly adjust insulin infusion for faster correction of hyperglycemia F. Start Iv infusion of normal saline

A,B,D,F Insulin should never be given subQ to someone in DKA, because the subQ tissues are dehydrated and poorly perfused as a result of dehydration and hypovolemic shock

A nurse is caring for a client who has SIADH. Which of the following findings should the nurse expect? (select all that apply) A. decreased serum sodium B. urine specific gravity 1.001 C. serum osmolality 230 mOsm/L D. polyuria E. increased thirst

A,C a decrease in serum sodium, and serum osmolality is caused by an increase in the secretion of ADH

A nurse is reviewing the health record of a client who has SIADH. which of the following lab findings should the nurse expect? (Select all that apply) A. low serum sodium B. High serum potassium C. Decreased urine osmolality D. High urine sodium E. Increased urine-specific gravity

A,D,E - SIADH results in water retention, causing a low serum sodium, high urine sodium, and increase in urine-specific gravity.

The nurse is assessing a patient with type 1 diabetes mellitus. The patient is confused and light-headed. The nurse should administer: A. 15-20g of simple sugar, such as juice B. 5 units of rapid-acting insulin C. IV infusion of 50% dextrose D. subQ glucagon

A.

A client has just been diagnosed with type 1 diabetes. When teaching the client and family how diet and exercise affect insulin requirements, the nurse should include which guideline? A. "you'll need less insulin when you exercise or reduce your food intake" B. "you'll need more insulin when you exercise or increase your food intake" C. "you'll need less insulin when you increase your food intake" D. "you'll need more insulin when you exercise or decrease your food intake"

A. "you'll need less insulin when you exercise or reduce food intake"

A nurse is caring for a female client with hypothyroidism. The client is extremely upset about her altered physical appearance. She doesnt want to take her medication because she doesnt believe its doing any good. What should the nurse do? A. tell her she'll soon experience improvement in her looks as the medication corrects her hormone deficiency. B. Tell her she'll feel better if she consistently takes the thyroid replacement medication C. tell the client that she looks fine and offer to help her with her makeup D. tell the client she needs to learn to accept herself as she is and be compliant during treatment

A. tell the client she'll soon experience improvement in her looks as the medication corrects her hormone deficiency.

A nurse is developing a teaching plan for a client who had a thyroidectomy and takes a thyroid hormone replacement. Which of the following instruction should the nurse plan to include? A. Take this medication on an empty stomach B. Take this medication with an antacid C. change position slowly while taking this medication D. Limit you fluid intake while taking this medication

A. this promotes proper absorption. and the client should not drink anything for 30 mins after taking it.

A nurse is reinforcing teaching with a client who has been prescribed levothyroxine (synthroid) to treat hypothyroidism. Which of the following should the nurse include in the teaching? (select all that apply) A. weight gain is expected B. Med should not be discontinued without advice from provider C. follow-up serum TSH levels should be obtained D. take the med on an empty stomach E. use fiber laxatives for constipation

B,C,D fiber laxatives reduce absorption of med and should be avoided

A nurse is collecting an admission history from a female client who has hypothyroidism. Which of the following findings are expected with this condition? (select all that apply) A. diarrhea B. Menorrhagia C. Dry skin D. increased libido E. hoarseness

B,C,E

A nurse is reviewing the clinical manifestations of hyperthyroidism with a client, which should she include (Select all that apply) A. dry skin B. Heat intolerance C. Constipation D. palpitations E Weight loss F bradycardia

B,D,E

A nurse is caring for a client who has diabetes insipidus. Which of the following urinalysis lab findings should the nurse anticipate? A. absence of glucose B. Decreased specific gravity C. Presence of Ketones D. presence of RBCs

B- decreased specific gravity The urine of a client with DI will be dilute and less than 1.005

A nurse is preparing to administer a morning dose of aspart insulin (novolog) to a client who has type 1 diabetes. Which of the following is an appropriate action by the nurse? A. check the clients BGL immediately after breakfast B. administer the insulin when breakfast arrives C. hold breakfast for an hour after insulin administration D. clarify the prescription because insulin should not be administered at this time

B. administer aspart insulin when breakfast arrives to avoid a hypoglycemic episode. aspart insulin is rapid acting and should be administerd 5-10 mins before breakfast.

A nurse is planning teaching for a client who has type 1 Diabetes mellitus. Which of the following information should the nurse include regarding alcohol consumption? A. Substitute two carbohydrate exchanges for every one alcoholic beverage B. ingest alcohol with meals to reduce alcohol-induced hypoglycemia C. Consuming alcohol decreases blood triglyceride levels D. Expect to increase insulin dosage when consuming alcohol

B. alcohol prevents liver production of glucose. Consuming Carbs while drinking helps prevent hypoglycemia The client might need to decrease insulin dosage due to the hypoglycemic effect of alcohol

A nurse is caring for a client who has diabetes mellitus and developed peripheral neuropathy. Which of the following measures should the nurse recommend to prevent injuries to his feet? A. examine feet weekly for alterations in skin integrity B. monitor the temperature of bath water with a thermometer C. shop for shoes early in the day D. round the edges of toenails when trimming

B. peripheral neuropathy makes it difficult to determine if the water is too hot

Which of the following factors in the focus of nutrition intervention for clients with type 2 diabetes? a) Protein metabolism b) Weight loss c) Blood glucose level d) Carbohydrate intake

B. weight loss Weight loss is the focus of nutrition intervention for clients with type 2 diabetes. A low-calorie diet may improve clinical symptoms; even a mild to moderate weight loss such as 10 to 20 lb may lower blood glucose levels and improve insulin action

A nurse is preparing to administer IV fluids to a client who has DKA. which of the following is an appropriate nursing action? A. administer an IV infusion of regular insulin at 0.3unit/kg/hr B. administer an IV infusion of 0.45% sodium chloride C. rapidly administer an IV infusion of 0.9% nacl D. add glucose to the IV infusion when serum glucose is 350

C

A nurse is assessing a client who is 12 hr postop following a thyroidectomy. Which of the following findings are indicative of a thyroid crisis? (select all that apply) A. bradycardia B. hypothermia C. tremors D. abdominal pain E. Mental confusion

C,D,E Excess levels of thyroid hormone can cause tremors, GI problems, and mental confusion

A nurse is caring for a client who is taking propylthiouracil (PTU). The nurse should recognize that the client has met the treatment goals when she reports in increase in which of the following? A. sweating B. Stools C. Weight D. Appetite

C. PTU suppresses the production of thyroid hormones and allows weight gain

A nurse is assessing a client who has adrenal insufficiency. Which of the following findings should the nurse expect? A. Moon face B. weight gain C. serum Calcium 12.8 mg/dl D. Serum sodium 150 mEq/dl

C. adrenal insufficiency causes serum calcium levels to be above the expected range

A nurse expects to note an elevated serum glucose level in a client with hyperosmolar hyperglycemic nonketotic sydrome (HHNS). which other lab finding should the nurse anticipate? a) Elevated serum acetone level b) Serum alkalosis c) Below-normal serum potassium level d) Serum ketone bodies

C. below-normal serum potassium level

A nurse is assessing a client who has SIADH. Which of the following findings indicates the client is experiencing a complication? A. decreased central venous pressure(CVP) B. increased urine output C. Distended neck veins D. Extreme thirst

C. distended neck veins this is a manifestation of fluid overload, which can lead to pulmonary edema and heart failure.

An instructor is preparing a teaching plan for a class on the various pituitary hormones. Which hormone would the instructor include as being released by the posterior pituitary gland? a) Prolactin b) Somatotropin c) Adrenocorticotropic hormone d) Oxytocin

D. oxytocin the posterior pituitary gland releases Oxytocin and ADH

Julie is a 32-year-old client who has an appointment at the weight loss clinic where you practice nursing. She has gained 55 lb in the last 3 years and is concerned about developing type 2 diabetes mellitus. Additionally, her healthcare provider told her that she has metabolic syndrome, and although her healthcare provider discussed that with her, she is asking the nurse to please review it with her again. What are the conditions which contribute to developing metabolic syndrome? Select all that apply. a) Low LDL b) All options are correct. c) Elevated blood glucose levels d) Abdominal obesity

C. elevated BGLs D. abdominal obesity

A nurse is providing care to a client whose BGL is 52. the client is lethargic but arousable. Which of the following actions should the nurse perform first? A. recheck BGL in 15 min B. provide a carb and a protein food C. provide 4 oz grape juice D. report findings to provider

C. grape juice The client needs a rapidly absorbed carb

A type 2 diabetic is ordered metformin (glucophage) as part of the management regime. Which is teh best nursing explanation for the action of this drug in controlling glucose levels? A. stimulates insulin release B. delays digestion of carbs C. helps tissues use insulin more effectively D. reduces the production of glucose by the liver

C. helps tissues use insulin more efficiently

A nurse is caring for a client following a thyroidectomy. the nurse should assess for which of the signs indicating hypoglycemia? A. strong, bounding pulse B. decreased bowel sounds C. tingling and numbness of the hands and feet D. diminished deep-tendon reflexes

C. hypocalcemia causes paresthesias, usually starting in the hands and feet. Hypocalcemia causes weak, thready pulse increased GI motility hyperactive DTR

A nurse obtains a fingerstick glucose level of 45 mg/dl on a client newly diagnosed with diabetes mellitus. the client is alert and oriented, and their skin is warm and dry. How should the nurse intervene? A. notify the physician B. give the client 4 oz of milk and a graham cracker with peanut butter C. obtain a repeat fingerstick glucose level D. obtain a serum glucose level

C. obtain a repeat fingerstick glucose level

A client with diabetic ketoacidosis was admitted to the intensive care unit 4 hours ago and has these laboratory results: blood glucose level 450 mg/dl, serum potassium level 2.5 mEq/L, serum sodium level 140 mEq/L, and urine specific gravity 1.025. The client has two I.V. lines in place with normal saline solution infusing through both. Over the past 4 hours, his total urine output has been 50 ml. Which physician order should the nurse question? a) Infuse 500 ml of normal saline solution over 1 hour. b) Hold insulin infusion for 30 minutes. c) Add 40 mEq potassium chloride to an infusion of half normal saline solution and infuse at a rate of 10 mEq/hour. d) Change the second I.V. solution to dextrose 5% in water.

D. Change the second I.V solution to dextrose 5% in water. the client should receive normal saline solution through the second IV until his BGL reaches 250. The client should receive a fluid bolus of 500 ml of normal saline solution. The client's urine output is low and his specific gravity is high, which reveals dehydration. The nurse should expect to hold the insulin infusion for 30 minutes until the potassium replacement has been initiated. Insulin administration causes potassium to enter the cells, which further lowers the serum potassium level. Further lowering the serum potassium level places the client at risk for life-threatening cardiac arrhythmias.

a 35 yo female client who complains of weight gain, facial hair, absent menstruation, frequent bruising, and acne is diagnosed with Cushing's syndrome. Cushing's syndrome is most likely caused by: A. adrenal carcinoma B. an inborn error of metabolism C. an ectopoic corticotropin-secreting tumor D. a corticotropin-secreting pituitary adenoma

D. a corticotropin-secreting pituitary adenoma

A patient is ordered desmopressin(DDAVP) for the treatment of diabetes insipidus. Which therapeutic response does the nurse anticipate the patient will experience? A. a decrease in blood pressure B. a decrease in appetite C. a decrease in blood glucose levels D. a decrease in urine output

D. a decrease in urine output.

A patient with a traumatic brain injury is producing an abnormally large volume of dilute urine. Which alteration to a hormone secreted by the posterior pituitary would the nurse expect to find? a) An increase in antidiuretic hormone b) An increase in oxytocin c) A deficient amount of somatostatin d) A deficient production of vasopressin

D. a deficient production of vasopressin

A home health nurse is assessing a client who is on lifelong hormone replacement therapy for the treatment of hypothyroidism. the client has not been taking his medication regularly. Which of the following findings should the nurse expect? A. significant weight loss B. persistent diarrhea C. tachycardia D. hypotension

D. hypotension is expected with hypothyroidism As well as Weight gain Constipation Bradycardia

A nurse is preparing a teaching plan for a client who has diabetes insipidus and is receiving intranasal desmopressin. Which of the following information should the nurse include in the teaching plan? A. daily fluid intake should be at least 3L B. obtain weight weekly at the same time of day wearing similar clothing C. Notify the provider if a weight loss of 0.45kg (1lb) or more per week is noted D. Occurrence of nocturia indicates the need for a dosage adjustment

D. the initial dose of desmopressin is administered in teh evening; the provider will increase the dosage until the client no longer experiences nocturia. Fluid intake should be limited to no more than 3L/day

A client with diabetic ketoacidosis has been brought into the ED where you work. Which of the following intervention is not a goal in the initial medical treatment of DKA? A. administer isotonic fluid at a high volume. B. monitor serum electrolytes and blood glucose levels C. administer glucose D. administer potassium replacements

c. Administer glucose Insulin is given IV. Insulin reduces the production of ketones by making glucose available for oxidation by the tissues and by restoring the liver's supply of glycogen. As insulin begins to lower the blood glucose level, the IV solution is changed to include one with glucose. Periodic monitoring of serum electrolytes and blood glucose levels is necessary. Isotonic fluid is instilled at a high volume, for example 250-500 mL/hour for several hours. The rate is adjusted once the client becomes rehydrated and diuresis is less acute. Potassium replacements are given despite elevated serum levels to raise intracellular stores.