Diabetic Ketoacidosis NCLEX Questions

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florahill10Preview Nclex Q 32 terms kar Which of the following is not a sign or symptom of Diabetic Ketoacidosis?*

• Positive Ketones in the urine
• Oliguria
• Polydipsia
• Abdominal Pain

B Oliguria means low urinary output....in DKA you have high urinary ouput (POLYURIA).A patient is admitted with Diabetic Ketoacidosis. The physician orders intravenous fluids of 0.9% Normal Saline and 10 units of intravenous regular insulin IV bolus and then to start an insulin drip per protocol. The patient's labs are the following: pH 7.25, Glucose 455, potassium 2.5.Which of the following is the most appropriate nursing intervention to perform next?*

• Start the IV fluids and administer the insulin bolus and drip as ordered
• Hold the insulin and notify the doctor of the potassium level of 2.5
• Hold IV fluids and administer insulin as ordered
• Recheck the glucose level

B Remember when insulin is given it helps take potassium back into the cell which will cause potassium blood levels to fall. Insulin therapy is to be started only if the patient's potassium level is 3.3 or greater.Which patient is MOST likely to develop Diabetic Ketoacidosis?*

• A 25 year old female newly diagnosed with Cushing's Disease taking glucocorticoids.
• A 36 year old male with diabetes mellitus who has been unable to eat the past 2 days due to a gastrointestinal illness and has been unable to

take insulin.

• A 35 year old female newly diagnosed with Type 2 diabetes.
• None of the options are correct.

B

Which of the following statements are INCORRECT about Diabetic Ketoacidoisis?*

• Extreme Hyperglycemia that presents with blood glucose >600 mg/dL
• Ketones are present in the urine
• Metabolic acidosis is present with Kussmaul breathing
• Potassium levels should be at least 3.3 or higher during treatment of DKA with insulin therapy

A Extreme Hyperglycemia that presents with blood glucose >600 mg/dL is present only in Hyperglycemic Hyperosmolar Nonketotic Syndrome.True or False: When priming the tubing for an Insulin infusion it is best practice to waste 50cc to 100cc of insulin prior to starting the infusion because insulin absorbs into the plastic lining of the tubing.* True False True You are providing care to a patient experiencing diabetic ketoacidosis. The patient is on an insulin drip and their current glucose level is 300. In addition to this, the patient also has 5% Dextrose 0.45% NS infusing in the right antecubital vein. Which of the following patient signs/symptoms causes concern?*

• Patient complains of thirst.
• Patient has a potassium level of 2.3
• Patient's skin and mucous membranes are dry.
• Patient is nauseous.

B Insulin causes potassium to enter back into the cell; therefore removing it from the blood. If the potassium is already 2.3, the patient can bottom out their potassium level. Therefore, the patient needs potassium supplements which requires a doctor's order.What type of insulin do you expect the doctor to order for treatment of DKA?*

• IV Novolog
• IV Levemir

C. IV NPH

• IV Regular Insulin

D A patient diagnosed with diabetes mellitus is being discharged home and you are teaching them about preventing DKA. What statement by the patient demonstrates they understood your teaching about this condition?*

• "I should not be alarmed if ketones are present in my urine because this is expected during illness."
• "It is normal for my blood sugar to be 250-350 mg/dL while I'm sick."
• "I will hold off taking my insulin while I'm sick."
• "It is important I check my blood glucose every 3-4 hours when I'm sick and consume liquids."

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