HESI CASE STUDY DIABETES MELLITUS COMPLETE QUESTIONS AND ANSWERS VERIFIED A+

HESI Case Study: Diabetes Mellitus
f9 f9 f9 f9




What is the mechanism that results in Kussmaul respirations?
f9 f9 f9 f9 f9 f9 f9 f9



A. To compensate for metabolic acidosis, the respirations are d
f9 f9 f9 f9 f9 f9 f9 f9 f9


eep and rapid.
f9 f9



B. To overcome respiratory acidosis, the respirations are fast a
f9 f9 f9 f9 f9 f9 f9 f9 f9


nd shallow.
f9



C. Injury to the brain's respiratory center results in periods of a
f9 f9 f9 f9 f9 f9 f9 f9 f9 f9 f9


pnea.
D. Hypoxemia causes labored, gasping, and irregular respiratio
f9 f9 f9 f9 f9 f9 f9


ns. - correct answer✔ ✔
f9 f9 f9


A. To compensate for metabolic acidosis, the respirations are
f9 f9 f9 f9 f9 f9 f9 f9 f


deep and rapid.
9 f9 f9




Rationale: To compensate for the ketoacidosis (metabolic acido
f9 f9 f9 f9 f9 f9 f9


sis), the lungs attempt to remove CO2 through a pattern of dee
f9 f9 f9 f9 f9 f9 f9 f9 f9 f9 f9


p, rapid respirations referred to as Kussmaul respirations.
f9 f9 f9 f9 f9 f9 f9




To achieve the goal of restoring the client's fluid volume, the n
f9 f9 f9 f9 f9 f9 f9 f9 f9 f9 f9


urse would expect to implement which intervention?
f9 f9 f9 f9 f9 f9



A. Insert a saline lock for PRN diuretic administration.
f9 f9 f9 f9 f9 f9 f9 f9



B. Administer an albumin/furosemide continuous infusion.
f9 f9 f9 f9 f9

,C. Maintain an infusion of normal saline solution.
f9 f9 f9 f9 f9 f9 f9



D. Obtain a type and crossmatch for 2 units of packed RBCs. -
f9 f9 f9 f9 f9 f9 f9 f9 f9 f9 f9 f9


correct answer✔ ✔
f9 f9


C. Maintain an infusion of normal saline solution.
f9 f9 f9 f9 f9 f9 f9




Rationale: The treatment of hyperglycemia includes fluid repla
f9 f9 f9 f9 f9 f9 f9


cement to correct dehydration caused by the increased concentr
f9 f9 f9 f9 f9 f9 f9 f9


ation of glucose in the blood. Isotonic fluids, such as normal s
f9 f9 f9 f9 f9 f9 f9 f9 f9 f9 f9


aline, are used initially to treat the dehydration.
f9 f9 f9 f9 f9 f9 f9




To restore the client's blood glucose to a normal level, what sh
f9 f9 f9 f9 f9 f9 f9 f9 f9 f9 f9


ould the nurse prepare to administer?
f9 f9 f9 f9 f9



A. An IV infusion containing regular insulin.
f9 f9 f9 f9 f9 f9



B. Humulin-N insulin SC before meals.
f9 f9 f9 f9 f9



C. 50% dextrose IV push.
f9 f9 f9 f9



D. Glucagon subcutaneously PRN per sliding scale. -
f9 f9 f9 f9 f9 f9 f9


correct answer✔ ✔
f9 f9


A. An IV infusion containing regular insulin.
f9 f9 f9 f9 f9 f9




Rationale: Continuous IV infusions containing regular insulin a
f9 f9 f9 f9 f9 f9 f9


re used to reduce the client's blood glucose level. The client's I
f9 f9 f9 f9 f9 f9 f9 f9 f9 f9 f9

,V solution will be changed to one that contains glucose when
f9 f9 f9 f9 f9 f9 f9 f9 f9 f9 f9


her blood glucose level reaches 250 mg/dl.
f9 f9 f9 f9 f9 f9




In addition to monitoring the client's blood glucose level, what
f9 f9 f9 f9 f9 f9 f9 f9 f9 f


9additional lab values should the nurse monitor carefully? (Sele
f9 f9 f9 f9 f9 f9 f9 f9


ct all that apply. One, some, or all options may be correct.)
f9 f9 f9 f9 f9 f9 f9 f9 f9 f9 f9



A. Uric acid.
f9 f9



B. Hemoglobin.
f9



C. Calcium.
f9



D. Potassium.
f9




E. Blood Urea Nitrogen (BUN). - correct answer✔ ✔
f9 f9 f9 f9 f9 f9 f9


B, C, D, E. f9 f9 f9 f9




Rationale: Though blood glucose and potassium are the most c
f9 f9 f9 f9 f9 f9 f9 f9 f9


ritical lab values to assess, hemoglobin levels may be altered r
f9 f9 f9 f9 f9 f9 f9 f9 f9 f9


elated to the state of hydration and should be monitored. Treat
f9 f9 f9 f9 f9 f9 f9 f9 f9 f9


ment with an IV insulin infusion will cause the potassium to re
f9 f9 f9 f9 f9 f9 f9 f9 f9 f9 f9


turn to the cells and may result in hypokalemia. Lara should b
f9 f9 f9 f9 f9 f9 f9 f9 f9 f9 f9


e closely monitored for symptoms of hypokalemia. Supplement
f9 f9 f9 f9 f9 f9 f9


al potassium may be added to the IV infusion to prevent or cor
f9 f9 f9 f9 f9 f9 f9 f9 f9 f9 f9 f9


rect this. Dehydration that occurs with DKA can lead to an inc
f9 f9 f9 f9 f9 f9 f9 f9 f9 f9 f9


reased BUN and should be monitored for signs of renal insuffi
f9 f9 f9 f9 f9 f9 f9 f9 f9 f9


ciency.

, Ethical-Legal Issues: Client Information f9 f9 f9



The client's blood glucose level stabilizes, and they begin takin
f9 f9 f9 f9 f9 f9 f9 f9 f9


g oral fluids. IV solutions are switched to dextrose 5% in sodi
f9 f9 f9 f9 f9 f9 f9 f9 f9 f9 f9


um chloride 0.45% at a keep-
f9 f9 f9 f9 f9


open rate, and the insulin infusion is discontinued.While hospit
f9 f9 f9 f9 f9 f9 f9 f9


alized, family members and many of the client's college friend
f9 f9 f9 f9 f9 f9 f9 f9 f9


s call the nursing unit to check on the client's condition.
f9 f9 f9 f9 f9 f9 f9 f9 f9 f9




The nurse's decision about what to tell these callers should be
f9 f9 f9 f9 f9 f9 f9 f9 f9 f9 f9


based on what primary consideration?
f9 f9 f9 f9



A. The instructions of the nursing unit supervisor.
f9 f9 f9 f9 f9 f9 f9



B. The nature of the caller's relationship to the client.
f9 f9 f9 f9 f9 f9 f9 f9 f9



C. The seriousness of the client's condition at the time of the c
f9 f9 f9 f9 f9 f9 f9 f9 f9 f9 f9 f9


all.
D. The client's right to privacy regarding her health informatio
f9 f9 f9 f9 f9 f9 f9 f9 f9


n. - correct answer✔ ✔
f9 f9 f9


D. The client's right to privacy regarding her health informati
f9 f9 f9 f9 f9 f9 f9 f9 f9


on.


Rationale: The Health Information Privacy Protection Act (HIP
f9 f9 f9 f9 f9 f9 f9


AA) stipulates that a client has the right to privacy regarding h
f9 f9 f9 f9 f9 f9 f9 f9 f9 f9 f9