Practice Quiz

CMSRN Medical-Surgical Nursing

Category - Endocrine

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Mr. Diaz, a 56-year-old candle maker, developed diabetic ketoacidosis (DKA) and is given intravenous normal saline infusion and regular insulin. In addition to hourly blood glucose monitoring, what assessment data are early signs of clinical improvement?
  1. Respiratory rate of 12 to 15 and normal BP in the standing position
  2. Temperature and pulse in normal range
  3. Improved level of consciousness and decreasing urine output
  4. Client eats a full meal and respiratory rate is normal
Explanation
Answer - C - Level of consciousness responds quickly to early changes in pH and restoration of fluid and electrolyte balance. Urine output decreases as hyperglycemia is resolved. The respiratory buffer system takes a few hours to respond to change in pH. Dehydration is usually so severe that several hours of rehydration are needed to reduce pulse (Choice B) and resolve orthostatic BP (Choice A). Choice D is inappropriate because eating a full meal is not an early sign of improvement.
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