Fluid and Electrolyte NCLEX Questions with Explanations

A nurse enters a client's room to administer an IV medication and finds that the IV site is swollen, cool, and pale. The client reports discomfort at the insertion site. The nurse recognizes that this may be: Infiltration Phlebitis. Sepsis. An allergic reaction.

Infiltration

Managing a sodium level of 120 in a client with diabetic ketoacidosis is correctly accomplished with: Intravenous 3% sodium chloride solution. Insulin and 0.9% sodium chloride. Fluid restriction. Oral salt tablets

Insulin and 0.9% sodium chloride

The health care provider prescribes an intravenous (IV) antibiotic to be administered in 50 mL 0.9% normal saline and to infuse in 30 minutes. The drop factor for the IV tubing is 15 gtt/mL. The nurse should set the flow rate of the infusion at how many drops per minute? 25 drops per minute 30 drops per minute 15 drops per minute 9 drops per minute

25 drops per minute In this question, you need to know the formula for calculating an IV flow rate. You will most likely learn about medication calculations and IV flow rates in your fundamentals nursing course. The formula and the calculation for this question are as follows: Total volume to be infused X Drop factor = Drops per minuteTime in minutes 50 × 15 = 2530

A client is in a state of uncompensated acidosis. The nurse would expect the arterial blood pH to be approximately? 6.9 7.45 7.48 7.2

7.2 The pH of the blood is maintained within the narrow range of 7.35 to 7.45. When there is an increase in hydrogen irons, acidosis results and is reflected in a lower pH.

The nurse reviews laboratory results and notes that a client's serum sodium level is 150 mEq/L (150 mmol/L). The nurse reports the serum sodium level to the health care provider (HCP) and the HCP prescribes dietary instructions based on the sodium level. Which acceptable food items does the nurse instruct the client to consume? Select all that apply. A. Peas B. Nuts C. Cheese D. Cauliflower E. Processed oat cereals

A, B, D Rationale: The normal serum sodium level is 135 to 145 mEq/L (135 to 145 mmol/L). A serum sodium level of 150 mEq/L (150 mmol/L) indicates hypernatremia. Based on this finding, the nurse would instruct the client to avoid foods high in sodium. Peas, nuts, and cauliflower are good food sources of phosphorus and are not high in sodium (unless they are canned or salted). Peas are also a good source of magnesium. Processed foods such as cheese and processed oat cereals are high in sodium content.

Potassium chloride intravenously is prescribed for a client with hypokalemia. Which actions should the nurse take to plan for the preparation and administration of the potassium? Select all that apply. A. Obtain an intravenous (IV) infusion pump. B. Monitor urine output during administration. C. Prepare the medication for bolus administration. D. Monitor the IV site for signs of infiltration or phlebitis. E.. Ensure that the medication is diluted in the appropriate volume of fluid. F. Ensure that the bag is labeled so that it reads the volume of potassium in the solution.

A, B, D, E, F Rationale: Potassium chloride administered intravenously must always be diluted in IV fluid and infused via an infusion pump. Potassium chloride is never given by bolus (IV push). Giving potassium chloride by IV push can result in cardiac arrest. The nurse should ensure that the potassium is diluted in the appropriate amount of diluent or fluid. The IV bag containing the potassium chloride should always be labeled with the volume of potassium it contains. The IV site is monitored closely because potassium chloride is irritating to the veins and there is a risk of phlebitis. In addition, the nurse should monitor for infiltration. The nurse monitors urinary output during administration and contacts the health care provider if the urinary output is less than 30 mL/hour.

The nurse is assigned to care for a group of clients. On reviewing the clients' medical records, the nurse determines which client is most likely at risk for a fluid volume deficit? A. A client with an ileostomy B. A client with heart failure C. A client on long-term corticosteroid therapy D. A client receiving frequent wound irrigations

A. A client with an ileostomy Rationale: A fluid volume deficit occurs when the fluid intake is not sufficient to meet the body's fluid needs. Causes of a fluid volume deficit include vomiting, diarrhea, conditions that cause increased respirations or increased urinary output, insufficient intravenous fluid replacement, draining fistulas, and the presence of an ileostomy or colostomy. A client with heart failure or on long-term corticosteroid therapy or a client receiving frequent wound irrigations is most at risk for fluid volume excess.

The client with acute renal failure asks the nurse for a snack. Because the client's potassium level is elevated, which of the following snacks is most appropriate? A. A gelatin dessert. B. Yogurt. C. An orange. D. Peanuts.

A. A gelatin dessert Rationale: Gelatin desserts contain little or no potassium and can be served to a client on a potassium-restricted diet. Foods high in potassium include bran and whole grains; most dried, raw, and frozen fruits and vegetables; most milk and milk products; chocolate, nuts, raisins, coconut, and strong brewed coffee.

An expected physiologic response to a low potassium level is: A. Cardiac dysrhythmias. B. Hyperglycemia. C. Hypertension. D. Increased energy.

A. Cardiac dysrhythmias. Rationale: Low potassium can cause an imbalance at the cellular level, leading to dysrhythmias and cardiac arrest. Hyperglycemia is caused by elevated blood sugar. Hypertension is unrelated to potassium levels. Increased energy is unrelated to potassium levels.

The client receives an I.V. infusion of 5% dextrose in normal saline running at 125 mL/hour. When hanging a new bag of fluid, the nurse notes swelling and hardness at the infusion site. The nurse should first: A. Discontinue the infusion. B. Apply a warm soak to the site. C. Stop the flow of solution temporarily. D. Irrigate the needle with normal saline

A. Discontinue the infusion Rationale: Signs of infiltration include slowing of the infusion and swelling, pain, hardness, pallor, and coolness of the skin at the site. If these signs occur, the I.V. line should be discontinued and restarted at another infusion site. The new anatomic site, time, and type of cannula used should be documented. The nurse may apply a warm soak to the site, but only after the I.V. line is discontinued. Parenteral administration of fluids should not be stopped intermittently. Stopping the flow does not treat the problem, nor does it address the client's needs for fluid replacement. Infiltrated I.V. sites should not be irrigated; doing so will only cause more swelling and pain.

The nurse assesses the client with chronic renal failure and notes the following: crackles in the lung bases, elevated blood pressure, and weight gain of 2 lb in 1 day. Based on these data, which of the following nursing diagnosis is appropriate? A. Excess fluid volume related to the kidney's inability to maintain fluid balance. B. Ineffective breathing pattern related to fluid in the lungs. C. Ineffective tissue perfusion related to interrupted arterial blood flow. D. Ineffective therapeutic regimen management related to lack of knowledge about therapy

A. Excess fluid volume related to the kidney's inability to maintain fluid balance. Rationale: Crackles in the lungs, weight gain, and elevated blood pressure are indicators of excess fluid volume, a common complication in chronic renal failure. The client's fluid status should be monitored carefully for imbalances on an ongoing basis. Although the client has ineffective breathing, the primary cause is related to renal failure. There are no data to suggest ineffective tissue perfusion or lack of knowledge.

The nurse assesses a client and notes puffy eyelids, swollen ankles, and crackles at both lung bases. The nurse understands that these clinical findings are most specifically associated with fluid excess in which of the following compartments? A. Interstitial compartment. B. Intravascular compartment. C. Extracellular compartment. D. Intracellular compartment

A. Interstitial compartment. Rationale: The clinical findings of edema are consistent with fluid excess in the interstitial compartment. The extracellular compartment consists of fluid in two locations, the interstitial (tissue) spaces and plasma (intravascular) spaces. Fluid shifts within the extracellular compartment can occur either from the plasma space to the interstitial space, or from the interstitial space to the plasma space. When fluid shifts from the plasma space into the interstitial space, usually as a result of abnormal retention of fluids in such conditions as heart failure or renal failure, edema results. The intracellular compartment consists of fluid within the cells.

The nurse reviews a client's laboratory report and notes that the client's serum phosphorus (phosphate) level is 1.8 mg/dL (0.45 mmol/L). Which condition most likely caused this serum phosphorus level? A. Malnutrition B. Renal insufficiency C. Hypoparathyroidism D. Tumor lysis syndrome

A. Malnutrition Rationale: The normal serum phosphorus (phosphate) level is 3.0 to 4.5 mg/dL (0.97 to 1.45 mmol/L). The client is experiencing hypophosphatemia. Causative factors relate to malnutrition or starvation and the use of aluminum hydroxide- based or magnesium based antacids. Renal insufficiency, hypoparathyroidism, and tumor lysis syndrome are causative factors of hyperphosphatemia.

A pt, experiencing multisystem fluid volume deficit, has the symptoms of tachycardia, pale, cool skin, & decreased urine output. The nurse realizes these findings are most likely a direct result of which of the following? A. the body's natural compensatory mechanisms B. pharmacological effects of a diuretic C. effects of rapidly infused intravenous fluids D. cardiac failure

A. The body's natural compensatory mechanisms Rationale 1: The internal vasoconstrictive compensatory reactions within the body are responsible for the symptoms exhibited. The body naturally attempts to conserve fluid internally, specifically for the brain & heart. Rationale 2: A diuretic would cause further fluid loss, & is contraindicated. Rationale 3: Rapidly infused intravenous fluids would not cause a decrease in urine output. Rationale 4: The manifestations reported are not indicative of cardiac failure in this pt.

Which client is at risk of developing a sodium level at 130 mEq/L (130 mmol/L)? A. The client who is taking diuretics B. The client with hyperaldosteronism C. The client with Cushing's syndrome D. The client who is taking corticosteroids

A. The client who is taking diuretics Rationale: The normal serum sodium level is 135 to 145 mEq/L (135 to 145 mmol/L). A serum sodium level of 130 mEq/L (130 mmol/L) indicates hyponatremia. Hyponatremia can occur in the client taking diuretics. The client taking corticosteroids and the client with hyperaldosteronism or Cushing's syndrome are at risk for hypernatremia.

The nurse is assessing a client with a suspected diagnosis of hypocalcemia. Which clinical manifestation would the nurse expect to note in the client? A. Twitching B. Hypoactive bowel sounds C. Negative Trousseau's sign D. Hypoactive deep tendon reflexes

A. Twitching Rationale: The normal serum calcium level is 9 to 10.5 mg/dL (2.25 to 2.75 mmol/L). A serum calcium level lower than 9 mg/dL (2.25 mmol/L) indicates hypocalcemia. Signs of hypocalcemia include paresthesia followed by numbness, hyperactive deep tendon reflexes, and a positive Trousseau's or Chvostek's sign. Additional signs of hypocalcemia include increased neuromuscular excitability, muscle cramps, twitching, tetany, seizures, irritability, and anxiety. Gastrointestinal symptoms include increased gastric motility, hyperactive bowel sounds, abdominal cramping, and diarrhea.

The nurse caring for a client who has been receiving intravenous (IV) diuretics suspects that the client is experiencing a fluid volume deficit. Which assessment finding would the nurse note in a client with this condition? A. Weight loss and poor skin turgor B. Lung congestion and increased heart rate C. Decreased hematocrit and increased urine output D. Increased respiration and increased blood pressure

A. Weight loss and poor skin turgor Rationale: A fluid volume deficit occurs when the fluid intake is not sufficient to meet the body's fluid needs. Assessment findings in a client with a fluid volume deficit include increased respirations and heart rate, decreased central venous pressure (CVP) (normal CVP is between 4 and 11 cm H2O), weight loss, poor skin turgor, dry mucous membranes, decreased urine volume, increased specific gravity of the urine, increased hematocrit, and altered level of consciousness. Lung congestion, increased urinary output, and increased blood pressure are all associated with fluid volume excess.

A client develops volume overload from an IV that has infused too rapidly. What assessments would the nurse expect to find? Hypoventilation Flattened neck veins Auscultation of an S3 heart sound Thready pulse

Auscultation of an S3 heart sound Auscultation of an S3 heart sound is the correct option. This is an early sign of volume overload (or CHF) because during the first phase of diastole, when blood enters the ventricles, an extra sound is produced due to the presence of fluid left in the ventricles.

The nurse is preparing to care for a client with a potassium deficit. The nurse reviews the client's record and determines that the client is at risk for developing the potassium deficit because of which situation? A. Sustained tissue damage B. Requires nasogastric suction C. Has a history of Addison's disease D. Uric acid level of 9.4 mg/dL (559 μmol/L)

B. Requires nasogastric suction Rationale: The normal serum potassium level is 3.5 to 5.0 mEq/L (3.5 to 5.0 mmol/L). A potassium deficit is known as hypokalemia. Potassium-rich gastrointestinal fluids are lost through gastrointestinal suction, placing the client at risk for hypokalemia. The client with tissue damage or Addison's disease and the client with hyperuricemia are at risk for hyperkalemia. The normal uric acid level for a female is 2.7 to 7.3 mg/dL (0.16 to 0.43 mmol/L) and for a male is 4.0 to 8.5 mg/dL(0.24 to 0.51 mmol/L). Hyperuricemia is cause of hyperkalemia.

The nurse is preparing to care for a client with a potassium deficit. The nurse reviews the client's record and determines that the client was at risk for developing the potassium deficit because of which situation? A. Sustained tissue damage B. Requires Nasogastric suction C. Has a history of Addison's disease D. Is taking a potassium-retaining diuretic

B: Requires Nasogastric suction Rationale: The normal serum potassium level is 3.5 mEq/L to 5.0 mEq/L. A potassium deficit is known as hypokalemia. Potassium-rich gastrointestinal fluids are lost through gastrointestinal suction, placing the client at risk for hypokalemia. The client with tissue damage or Addison's disease and the client taking a potassium-retaining diuretic are at risk for hyperkalemia.

A postoperative client has been placed on a clear liquid diet. The nurse should provide the client with which items that are allowed to be consumed on this diet? Select all that apply. A. Broth B. Coffee C. Gelatin D. Pudding E. Vegetable juice F. Pureed vegetables

Broth, Coffee, gelatin Rationale: A clear liquid diet consists of relatively transparent foods to light and are clear and liquid at room and body temperature. These foods include items such as water, bouillon, clear broth, carbonated beverages, gelatin, hard candy, lemonade, ice pops, and regular or decaffeinated coffee or tea. The incorrect food items are items that are allowed on a full liquid diet.

The nurse is caring for a client with heart failure. On assessment, the nurse notes that the client is dyspneic (labored breathing), and crackles are audible on auscultation. What additional manifestations would the nurse expect to note in this client if excess fluid volume is present? A. Weight loss and dry skin B. Flat neck and hand veins and decreased urinary output C. An increase in blood pressure and increased respirations D. Weakness and decreased central venous pressure (CVP)

C. An increase in blood pressure and increased respirations Rationale: A fluid volume excess is also known as overhydration or fluid overload and occurs when fluid intake or fluid retention exceeds the fluid needs of the body. Assessment findings associated with fluid volume excess include cough, dyspnea, crackles, tachypnea, tachycardia, elevated blood pressure, bounding pulse, elevated CVP, weight gain, edema, neck and hand vein distention, altered level of consciousness, and decreased hematocrit. Dry skin, flat neck and hand veins, decreased urinary output, and decreased CVP are noted in fluid volume deficit. Weakness can be present in either fluid volume excess or deficit.

A client with Addison's disease is admitted to the medical unit. The nurse diagnoses the client with Deficient fluid volume related to inadequate fluid intake and fluid loss secondary to inadequate adrenal hormone secretion. As the client's oral intake increases, which of the following fluids would be most appropriate? A. Milk and diet soda. B. Water and eggnog. C. Bouillon and juice. D. Coffee and milkshakes.

C. Bouillon and juice Rationale: Electrolyte imbalances associated with Addison's disease include hypoglycemia, hyponatremia, and hyperkalemia. Salted bouillon and fruit juices provide glucose and sodium to replenish these deficits. Diet soda does not contain sugar. Water could cause further sodium dilution. Coffee's diuretic effect would aggravate the fluid deficit. Milk contains potassium and sodium.

The nurse is caring for a client with heart failure who receives high doses of a diuretic. On assessment, the nurse notes that the client has flat neck veins, generalized muscle weakness, and diminished deep tendon reflexes. The nurse suspects hyponatremia. What additional signs would the nurse expect to note in a client with hyponatremia? A. Muscle twitches B. Decreased urinary output C. Hyperactive bowel sounds D. Increased specific gravity of the urine

C. Hyperactive bowel sounds Rationale: The normal serum sodium level is 135 to 145 mEq/L (135 to 145 mmol/L). Hyponatremia is evidenced by a serum sodium level lower than 135 mEq/L (135 mmol/L). Hyperactive bowel sounds indicate hyponatremia. The remaining options are signs of hypernatremia. In hyponatremia, muscle weakness, increased urinary output, and decreased specific gravity of the urine would be noted.

The nurse is reading a health care provider's (HCP's) progress notes in the client's record and reads that the HCP has documented "insensible fluid loss of approximately 800 mL daily." The nurse makes a notation that insensible fluid loss occurs through which type of excretion? A. Urinary output B. Wound drainage C. Integumentary output D. The gastrointestinal tract

C. Integumentary output Rationale: Insensible losses may occur without the person's awareness. Insensible losses occur daily through the skin and the lungs. Sensible losses are those that the person is aware of, such as through urination, wound drainage, and gastrointestinal tract losses.

The nurse prepares for the possibility of magnesium sulfate toxicity by having at the beside: Calcium gluconate Oxygen Nalline Suction equipment

Calcium gluconate The antagonist of magnesium sulfate is calcium gluconate, and it needs to be at the bedside.

You are caring for a client with severe hypokalemia. The physician has ordered IV potassium to be administered at 10 mEq/hr. The client complains of burning along their vein. What should you do? A. Change the electrolyte. B. Switch to an oral formulation. C. Increase the speed of transfusion. D. Dilute the infusion

D. Dilute the infusion Rationale: Treatment of severe hypokalemia requires treatment with IV infusion of potassium. Clients may experience burning along the vein with IV infusion of potassium in proportion to the infusion's concentration. If the client can tolerate the fluid, consult with the physician about diluting the potassium in a larger volume of IV solution. Oral potassium may not be enough in severe cases of hypokalemia. Hypokalemia requires treatment with potassium and not any other electrolyte.

The client's serum potassium level is elevated in acute renal failure, and the nurse administers sodium polystyrene sulfonate (Kayexalate). This drug acts to: A. Increase potassium excretion from the colon. B. Release hydrogen ions for sodium ions. C. Increase calcium absorption in the colon. D. Exchange sodium for potassium ions in the colon.

D. Exchange sodium for potassium ions in the colon Rationale: Polystyrene sulfonate, a cation-exchange resin, causes the body to excrete potassium through the gastrointestinal tract. In the intestines, particularly the colon, the sodium of the resin is partially replaced by potassium. The potassium is then eliminated when the resin is eliminated with feces. Although the result is to increase potassium excretion, the specific method of action is the exchange of sodium ions for potassium ions. Polystyrene sulfonate does not release hydrogen ions or increase calcium absorption.

A nurse is caring for a client with metastatic breast cancer who is extremely lethargic and very slow to respond to stimuli. The laboratory report indicates a serum calcium level of 12.0 mg/dl, a serum potassium level of 3.9 mEq/L, a serum chloride level of 101 mEq/L, and a serum sodium level of 140 mEq/L. Based on this information, the nurse determines that the client's symptoms are most likely associated with which electrolyte imbalance? A. Hypocalcemia B. Hyperkalemia C. Hypokalemia D. Hypercalcemia

D. Hypercalcemia Rationale: The normal reference range for serum calcium is 9 to 11 mg/dl. A serum calcium level of 12 mg/dl clearly indicates hypercalcemia. The client's other laboratory findings are within their normal ranges, so the client doesn't have hypernatremia, hypochloremia, or hypokalemia.

The nurse monitors the serum electrolyte levels of a client who is taking digoxin (Lanoxin). Which of the following electrolyte imbalances is a common cause of digoxin toxicity? A. Hyponatremia. B. Hypomagnesemia. C. Hypocalcemia. D. Hypokalemia.

D. Hypokalemia Rationale: Hypokalemia is one of the most common causes of digoxin (Lanoxin) toxicity. It is essential that the nurse carefully monitor the potassium levels of clients taking digoxin to avoid toxicity. Low serum potassium levels can cause cardiac dysrhythmias.

Which client is at risk of developing a potassium level of 5.5 mEq/L (5.5 mmol/L)? A. The client with colitis B. The client with Cushing's syndrome C. The client who has been overusing laxatives D. The client who has sustained a traumatic burn

D. The client who has sustained a traumatic burn Rationale: mmol/L). A serum potassium level higher than 5.0 mEq/L (5.0 mmol/L) indicates hyperkalemia. Clients who experience cellular shifting of potassium in the early stages of massive cell destruction, such as with trauma, burns, sepsis, or metabolic or respiratory acidosis, are at risk for hyperkalemia. The client with Cushing's syndrome or colitis and the client who has been overusing laxatives are at risk for hypokalemia.

Which IV fluid order is most appropriate for a client on dialysis? NS at 150 mL/hr. D5 1/2NS at 20 mL/hr. 1/4NS with 20 mEq KCl at 75 mL/hr. D10W with 40 mEq KCl at 50 mL/hr.

D5 1/2NS at 20 mL/hr. This is correct because clients on dialysis should receive minimal fluids and no potassium, since these agents cannot be removed until the next dialysis treatment. NS at 150 mL/hr is incorrect because this IV rate is too fast for a client who is unable to excrete fluids via the kidney. The two other options are incorrect because potassium is rarely given to clients requiring dialysis since they are unable to secrete any excess.

The laboratory values for an adult client who is NPO are: Na+ 128, K+ 3.5, and glucose 130. Which IV solution should a nurse expect will be ordered? D10W with 40 mEq KCl/L at 150 mL/hr. D51/4NS at 50 mL/hr. D5NS with 20 mEq KCl/L at 75 mL/hr. 1/4NS with 20 mEq KCl/L at 100 mL/hr.

D5NS with 20 mEq KCl/L at 75 mL/hr. correct because the client needs potassium, which cannot be replaced with enteral feedings. Fluids are needed when NPO, but the low serum sodium should not be further diluted with rapid administration of hypotonic solutions; thus, normal saline is appropriate. Even though the blood sugar is slightly elevated, it is appropriate to give clients who are NPO some energy source. Dextrose 5% contains only 17 calories/100 mL.

The nurse administers serum albumin to a client to assist in? Clotting of blood Formation of red blood cells Activation of white blood cells Development of osmotic pressure

Development of osmotic pressure Blood albumin, a protein, establishes the plasma colloid osmotic pressure because of its high molecular weight and size, which helps prevent cerebral edema postoperatively.

Which solution will a client most likely receive for fluid replacement in the first 24 hours after a burn injury that covers a large area? Normal saline with added K+. Dextran. D5W. Lactated Ringer's.

Lactated Ringer's. Correct because a crystalloid, such as lactated Ringer's, will correct the volume deficit, sodium loss, and metabolic acidosis that is present in the client with burns.

A nurse knows that a client with hypercalcemia may experience: Select all that apply. Thirst. Constipation. Hyperactivity. Diarrhea. Loss of appetite. Feeling sleepy.

Loss of appetite. Feeling sleepy. Thirst Constipation Thirst is correct because severe thirst may be secondary to the polyuria from the high solute (calcium) load. Constipation is correct because constipation is a common side effect from decreased tone in the bowel. Loss of appetite is correct because the high calcium increases gastric acid secretion and may intensify gastrointestinal manifestation. Anorexia, nausea, and vomiting are intensified by increased gastric residual volume. Feeling sleepy is correct because high calcium levels depress brain function, leading to ↓ activity.

A client admitted with squamous cell carcinoma of the lung has a serum calcium level of 14 mg/dl. The nurse should instruct the client to avoid which of the following foods upon discharge? Select all that apply: Eggs Nuts Organ meats Fish Broccoli Canned salmon

Nuts Broccoli Canned salmon Fish, eggs, and organ meats are high in phosphorus. Broccoli, nuts, and canned salmon are high in calcium. Clients with lung or breast cancer often have elevated calcium levels due to tumor-induced hyperparathyroidism.

The nurse is caring for a client on digitalis. For which electrolyte abnormality should the nurse assess to minimize the risk of digitalis toxicity? Magnesium 1.0 mEq/L Sodium 132 mEq/L Potassium 3.0 mEq/L Calcium 9.2 mEq/L

Potassium 3.0 mEq/L A low serum potassium level (normal 3.5-5.1mEq/L) enhances the action of digitalis and predisposes the client receiving digitalis to develop toxicity.Hyponatremia, hypomagnesemia, and a normal calcium level do not contribute to digitalis toxicity.

The client is admitted with a blood glucose level of 545 mg/dl. Which action by the nurse indicates that the nurse is aware of the client's needs? The nurse inserts a Foley catheter. The nurse prepares an IV of D10W. The nurse prepares to administer insulin IV. The nurse obtains NPH insulin for administration.

The nurse prepares to administer insulin IV The client with a blood glucose of 545 mg/dl is in metabolic acidosis. An IV with insulin will be ordered. IV of D10W will not be given as this will increase the glucose level and potentiate the client's condition. Regular insulin will be ordered, not NPH, which is long-acting. Although a Foley catheter might be ordered, it is not necessary for the improvement of the client's condition.