Endocrine Flashcards
1
Q
A nurse is caring for a client who is postoperative following a bilateral adrenalectomy. The nurse should expect to administer glucocorticoids following the procedure to enhance which of the following therapeutic effects?
A. compensate for decrease in cortisol levels
B. inhibit glucose metabolism
C. Act as a diuretic to maintain urine output
D. Decrease susceptibility to infection
A
A. compensate for decrease in cortisol levels
2
Q
A client who has an adrenalectomy requires glucocorticoids before, during, and after surgery to prevent an _____ caused by a sudden drop in cortisol levels.
A
adrenal crisis
3
Q
The client who has an adrenalectomy has increased ________ levels due to the increase in production of glucocorticoids. Glucocoricoids stimulate gluconeogenesis and are not given to inhibit glucose metabolism.
A
blood glucose
4
Q
The client who has an adrenalectomy has an increased risk for infection due to the increase in production of glucocorticoids. Glucocorticoids have potent anti-inflammatory and _________ properties and increase the client’s susceptibility to infection.
A
v
5
Q
A nurse is planning a community health screening for a group of clients who are at risk for type 2 diabetes mellitus. Which of the following clients should the nurse include in the screening?
A. men who smoke
B. Men and women who are obese
C. Women who have hepatitis
D. Men and women who consume high protein and low carb foods.
A
B. Men and women who are obese
6
Q
There is a high correlation between ______ and type 2 diabetes.
A
obesity
7
Q
A nurse is providing teaching to a client who has type 1 diabetes mellitus about hypoglycemia. Which of the following manifestations should the nurse include in the teaching?
A. Shakiness
B. Urinary frequency
C. Dry mucous membranes
D. Excess thirst
A
A. shakiness
8
Q
The client who has hypoglycemia can experience early manifestations of shakiness. Other early manifestations include fatigue, headache, difficulty thinking, ______, and nausea.
A
sweating
9
Q
The client who has hyperglycemia will have manifestations of increased _______ called polyuria.
A
urination
10
Q
The client who has _______ will have manifestations of excess thirst called polydipsia.
A
hyperglycemia
11
Q
The client who has hyperglycemia will have manifestations of dehydration, such as dry mucous membranes and ______.
A
sunken eyeballs
12
Q
A nurse is caring for a client who has type 2 diabetes mellitus and is displaying manifestations of hyperglycemia. Which of the following findings should indicate to the nurse that the client has hyperglycemia?
A. Hunger
B. Increased urination
C. Cold, clammy skin
D. Tremors
A
B. Increased urination
13
Q
Increased hunger is a manifestation of _____ due to a cholinergic response from central glucose deprivation.
A
hypoglycemia
14
Q
Cold, clammy skin is a manifestation of _____ due to a cholinergic response from central glucose deprivation.
A
hypoglycemia
15
Q
Tremulousness is a manisfestation of _____ due to an adrenergic response from central glucose deprivation.
A
hypoglycemia
16
Q
A nurse is reviewing the lab values of a client who has diabetic ketoacidosis. The nurse should understand that which of the following lab values is consistent with diabetic ketoacidosis?
A. Blood glucose 30 mg/dL
B. Negative urine ketones
C. Blood pH 7.28
D. BIcarbonate level 12 mEq/L
A
D. BIcarbonate level 12 mEq/L
17
Q
The client who has diabetic ketoacidosis should have a bicarbonate level less than ______ b/c the client has an increased production of counter-regulatory hormones that lead to metabolic acidosis.
A
15 mEq/L
18
Q
The client who has diabetic ketoacidosis should have a pH level less than ______ because the client has an increased production of counter-regulatory hormones that lead to metabolic acidosis.
A
7.3
19
Q
The client who has diabetic ketoacidosis should have ________ ketones because of the increased production of counter-regulatory hormones that lead to the production of ketoacids.
A
positive urine ketones
20
Q
The client who has diabetic ketoacidosis should have a blood glucose level greater than ______ mg/dL, which will cause spilling of ketones in the urine and development of metabolic acidosis.
A
250 mg/dL
21
Q
A nurse is preparing a 24-hour urine specimen for a client who is suspected to have pheochromocytoma. Which of the following lab tests from the 24-hour urine specimen should the nurse use to determine the client’s condition?
A. creatinine clearance
B. Vanillymandelic acid (VMA)
C. 17-hydroxycorticosteroids (17-OHCS)
D. Protein
A
Vanilylmandelic acid (VMA) - measures the level of catecholamine metabolites in a 24 hour urine sample
22
Q
A 24 hour urine specimen for creatinine clearance is used to evaluate the client’s ______ function by calculating the glomerular filtration rate of the kidneys.
A
renal
23
Q
A 24 hour urine specimen for 17-OHCS is used to determine if the client is producing an adequate amount of ______. An increase of ______ in the 24 hour urine specimen can indicate the client has Cushing’s disease.
A
cortisol
cortisol
24
Q
A 24 hour urine specimen for protein is used to evaluate the client’s _____ function.
A
renal
25
A nurse is providing teaching to a client who has type 1 diabetes mellitus about exercise. Which of the following statements should the nurse include in the teaching?
A. you should exercise during a peak insulin time
B. wear a medical alert identification tag when you exercise
C. exercise can decrease the effects of insulin and cause the blood glucose levels to increase.
D. You will get the most benefit from exercise when your glucose levels are higher than normal.
B. wear a medical alert identification tag when you exercise
26
The nurse should avoid exercising within _____ of receiving the insulin, or at the peak time of insulin, because exercise can increase the absorption of the insulin at the injection site and cause the client to have a marked drop in blood sugar at the insulin peak time.
1 hour
27
The client who exercises can potentiate the effects of insulin and cause the blood glucose levels to ____.
decrease
28
The client who has poorly controlled insulin dependent diabetes mellitus is taught not to exercise when blood glucose levels are greater than ______, or if ketones are noted in the urine.
250 mg/dL
29
A nurse is caring for a client who is postoperative following a parathyroidism. Which of the following lab values should the nurse expect to decrease as a therapeutic effect of the procedure?
A. calcium
B> sodium
C. Potassium
D. Phosphorous
A. Calcium
30
The _______ hormone regulates calcium, phosphorous, and magnesium balance within the client's blood and bone by maintaining a balance between the mineral levels in the blood and the bone.
parathyroid
31
hyperparathyroidism is associated with _______, therefore, a decrease in the calcium level indicates an improvement in the client's condition.
hypercalcemia
32
Hyperparathyrodism is associated with hypophosphatemia; therefore, an increase in the phosphorous level indicates an _____ in the client's condition.
improvement
33
A nurse is caring for a client who had a thyroidectomy to treat hyperthyroidism caused by an adenoma. Which of the following findings should the nurse report to the provider? (select all that apply.)
A. Tachycardia and Hypertension
B. Respiratory rate 16/min
C> Negative Chvostek's sign
D. Laryngeal stridor and hoarseness
E. Positive Trousseau's sign
A. Tachycardia and hypertension
D. Laryngeal stridor and hoarseness
E. Positive Trousseau's sgin
34
A nurse is planning care for a client who is experiencing the Somogyi effect and takes intermittent-acting insulin. Which of the following actions should the nurse include in the plan?
A. move the evening intermediate acting insulin dose to 90 min before dinner.
B. Increase the client's morning caloric intake.
C. Omit the client's evening snack
D. Monitor the client's nighttime blood glucose levels
D. Monitor the client's nighttime blood glucose levels
35
The Somogyi effect is a swing of a high blood glucose level in the ___________ level during the night. The swing is caused by the release of stress hormones to counter low glucose levels. Monitoring the client's nighttime blood glucose levels time can provide an accurate diagnosis of the Somogyi effect.
morning after an extremely low blood glucose
36
The nurse should evaluate the client's evening caloric intake based on the insulin dose and exercise programs during the day to avoid conditions that can lead to the _______.
Somogyi effect
37
The nurse should plan to administer a smaller dose of intermediate-acting insulin at bedtime, or increase the client's bedtime ______ to avoid conditions that can lead to the Somogyi effect.
snacks,
38
A nurse is assessing a client who has Graves' disease. Which of the following findings should the nurse expect the client to display?
Constipation
Cold intolerance
Difficulty sleeping
Anorexia
Difficulty sleeping
39
The client who has Grave's disease should have an increase in ________ and still experience weight loss because of the overproduction of thyroid hormone.
appetite
40
The client who has Grave's disease can experience ______ due to the overproduction of thyroid hormone.
heat intolerance
41
A nurse is monitoring a client who has syndrome inappropriate antidiuretic hormone secretion (SIADH). Which of the following findings should the nurse expect?
Polyuria
Dehydration
Hyponatremia
Hyperthermia
Hyponatremia
42
The client who has SIADH will ____ free water in the circulatory system, which is due to excess antidiuretic hormone.
retain
43
A nurse is planning care for a client who has Cushing's syndrome due to chronic corticosteroid use. Which of the following actions should the nurse include in the plan of care?
Check the client's blood glucose for hypoglycemia
Check the client's urine specific gravity
Weight the client weekly
Insert an indwelling urinary catheter for the client
Check the client's urine specific gravity
44
The nurse should check the Cushing's client's urine specific gravity to assess for _______.
fluid volume overload
45
A nurse is caring for a client who has diabetes insipidus. For which of the following findings should the nurse monitor?
Proteinuria
Oliguria
Polyuria
Glycosuria
Polyuria (increased urination)
46
Diabetes insipidus is characterized by polydipsia, which is ______.
increased thirst
47
Protein in the urine is a manifestation of ________.
kidney disease (proteinuria)
48
_______ in the urine is a manifestation of type 1 diabetes mellitus.
Glucose
49
A nurse is providing teaching to a client who has type 2 diabetes mellitus about the pathophysiology of the disease. Which of the following statements by the client indicates an understanding of the teaching?
A. my cells are resistant to the effects of insulin
B. my body breaks down sugars too efficiently
C. My pancreas does not produce insulin
D. my body produces antibodies against pancreatic beta cells
A. my cells are resistant to the effects of insulin
50
The client who has type 2 diabetes mellitus will have resistance to insulin and a decrease in the secretion of insulin by the _____.
pancreatic beta cells
51
The client who has type 1 diabetes melitus does not secrete ________ because of the destruction of the beta cells by the body.
insulin
52
Although insulin is still produced by the client who has type 2 diabetes mellitus, it is of _______ quantity to maintain homeostasis.
insufficient
53
The client who has type 1 diabetes mellitus has destruction of the beta cells because of the body producing ________.
blood antibodies
54
A nurse is assessing a client who has manifestations of acromegaly. Which of the following findings should the nurse expect?
A. Thinning of skeletal bone structure
B. Concave chest wall
C. High pitched voice
D. Increased head size
D. Increased head size
55
The client who has acromegaly will manifest an enlarged head size due to the excessive production of growth hormones after closing of the ________ (the growth plate) by the pituitary gland. It results in the gradual enlargement of the client's body tissues, such as the bones of the face, jaw, hand, feet, and skull.
epiphyses
56
The pt who has acromegaly will have a ________ of the voice due to hypertrophy of the vocal cords from an increase in growth hormones secreted by pitutiary gland.
deepening
57
The client who has acromegaly will manifest a ______ chest due to the increase of growth hormones that enlarge the skeletal system.
barrel-shaped
58
The client who has acromegaly will have ______ due to the increase of growth hormones secreted by the pituitary gland.
skeletal thickening
59
A nurse is monitoring a client who has Graves' disease for the development of thyroid storm. The nurse should report which of the following findings of the provider?
A. constipation
B. headache
C. bradycardia
D. hypertension
hypertension
60
The client who is experiencing a thyroid storm will have _______, abdominal pain, nausea, and vomiting.
diarrhea
61
The client who is experiencing a thyroid storm will have restlessness, confusion, and possible ______.
seizures
62
Graves' disease is a common cause of _______, which is an imbalance of metabolism caused by overproduction of the thyroid hormone.
hyperthyroidism
63
A nurse is checking lab values to determine if a client who has diabetes mellitus is adhering to the treatment plan. Which of the following tests should the nurse use to make this determination?
Glycosylated hemoglobin levels
Urine sugar and acetone
Glucose tolerance test
Fasting serum glucose
Glycosylated hemoglobin levels or HbA1c
64
A _____ test is used to diagnose diabetes mellitus and most commonly identifies type 2 and gestational diabetes.
glucose tolerance
65
A _____ test provides the nurse with information about the previous 24 hours.
fasting serum glucose
66
A nurse is assessing a client who has Addison'ts disease. Which of the following skin manifestations should the nurse expect to find?
Purple striae on the chest and abdomen
Butterfly rash across the bridge of the nose
Bronze pigmentation of skin
Jaundice of the face and sclera
Bronze pigmentation of the skin (darkening
67
The client who has ______ disease should have purple striae (streaks or stripes) on the chest and abdomen.
Cushings
68
A nurse is providing teachign to a client who has Addison's disease about healthy snack foods. Which of the following food choices by the client indicates an understanding of the teaching?
Sliced bananas
baked potato
turkey and cheese sandwhich
plain yogurt with peaches
turkey and cheese sandwhich
| high protein, carb and sodium
69
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. laryngeal stridor
B. productive cough
C. pain and hyperextension of the neck
D. hoarse, weak voice
Laryngeal stridor
70
Laryngeal stridor is a harsh, high pitched sound with inspiration that indicates _______. The nurse should take immediate action to preserve the airway.
respiratory obstruction
71
A ______, ______ voice is common after general anesthesia as a result of endotracheal intubation. If horarseness continues, it could indicate laryngeal nerve damage, which is usually ______.
hoarse, weak
| transient
72
After a thyroidectomy teach the pt to
A. take the med on an empty stomach
B. take med with an antacid
C. change position slowly
D. Limit your fluid intake while taking this med
A. take the med on an empty stomach
73
A nurse is caring for a client who is taking proplythiouracil. The nurse should identify that the client has met the treatment goals when she reports an increase in which of the following manifestations?
A. sweating
B. Stools
C. Weight
D. Appetite
C. weigh
74
PTU suppresses teh production of _____ and therefore, allows for weight gain.
thyroid hormones
75
PTU decreases manifestations of _______.
hyperthyroidism
76
A nurse is assessing a client who has diabetes mellitus and reports feeling anxious. Which of the following findings should the nurse expect if the client is hypoglycemic?
A. rapid, deep respirations
B. cool, clammy skin
C. abdominal cramping
D. orthostatic hypotension
Cool clammy skin
77
Hypoglycemia causes cool, clammy skin, in addition to anxiety, nervousness, tachycardia, and _____.
confusion
78
Rapid, deep respirations are an expected finding with ______glycemia.
hyperglycemia
79
Abdominal cramping is an expected finding with _____ glycemia
hyper
80
Hyperglycemia can cause _______, resulting in hypotension.
dehydration
81
A nurse is assessing a client who has adrenal insfufficiency. Which of the following findings should the nurse expect?
A. moon face
B. weight gain
C. calcium 12.8
D. sodium 150 mEq/L
C. calcium 12.8
82
Weight loss is a finding of adrenal _____.
insufficiency
83
A nurse is teaching a client who has an autoimmune disease about the adverse effects of long-term corticosteroid therapy. Which of the following effects should the nurse include? (select all that apply)
A. osteoporosis
B. Moon shaped face
C. Increased Risk of infection
D. Hearing loss
E. weight loss
Osteoporosis
Moon shaped face
Increased risk of infection
84
Long term coticosteroid therapy can cause cataracts and _______, but not hearing loss.
glaucoma
85
Long term corticosteroid therapy is more likely to cause _____ due to the fluid and sodium retention these medications cause.
weight gain
86
A nurse is teaching a client who has diabetes mellitus about insulin injections. The client's prescription includes evening doses of insulin glargine and regular insulin. Which of the following instructions should the nurse include?
Inject the insulins intramuscularly
Shake the insulins vigorously prior to administration
Draw up the insulins into separate syringes
Expect the insulins to appear cloudy.
Draw up the insulins into separate syringes
87
The nurse should instruct the client to draw up the insulins into separate syringes because insulin glargine is _____ with other insulins.
not compatible
88
A nurse is teaching a client about the adrenocorticotropic hormone (ACTH) stimulation test. The nurse should explain that the purpose of the test is to assess for which of the following disorders?
Diabetes insipidus
Hyperthyroidism
Pheochromocytoma
Addison's disease
Addison's disease
89
The ACTH stimulation test measures the __________ stimulation test is the standard test for Addison's disease. It measure the cortisol response to ACTH. The response is absent or very decreased in clients who have primary adrenal insufficiency.
cortisol
90
A 24 hour urine collection can detect catecholamines and other substances that can indicate _________.
pheochromocytoma
91
A thyroid scan and a thyroid stimulating hormone test are used diagnose _______.
hyperthyroidism
92
A 24 hour I&O, urine specific gravity, and urine osmolarity are used to diagnose __________.
diabetes insipidus
93
A home health nurse is assessing a client who requires 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?
Increased urine output
Persistent diarrhea
Tachycardia
Hypotension
Hypotension
94
Hypotension is an expected finding with hypothyroidism, along with bradypnea, dysrhytmias, cold intolerance, and ____, _____ skin.
cool, dry skin
95
A nurse is assessing a client who has syndrome of inappropriate antidiurectic hormone (SIDADH). Which of the following findings should the nurse report to provider?
Sodium 110 mEq/L
2+ deep tendon reflexes
Potassium 3.7 mEq/L
Urine specific gravity 1.025
Sodium 110 mEq/L
retaining fluids causes dilutional hyponatremia
96
A nurse is caring for a client following a thyroidectomy. The nurse should assess for which of the following findings as an indication of hypocalcemia?
Strong, bounding pulse
Decreased bowel sounds
Tingling and numbness of the hands and feet
Diminished deep tendon reflexes
Tingling and numbness of the hands and feet
97
_____ calcemia causes hyperactive deep tendon reflexes
hypo
98
____calcemia causes paresthesias, which usually starts in the hands and feet.
hypo
99
_____calcemia increases gi motility.
hypo
100
A nurse is providing discharge teaching for a client who has diabetes insipidus and has a new prescription for desmopressin nasal spray. Which of the following instructions should the nurse include in the teaching?
Depress the pump once before using the nasal spray for the first time.
Blow your nose gently prior to using the nasal for the first time.
Administer the nasal spray while in a side lying position.
Instill the medication four times per day
Blow your nose gently prior to using the nasal for the first time.
* This action prevents dilution of the medication with nasal secretions
101
A nurse is managing the care of a client who is postoperative and has acute adrenal insufficiency. Which of the following actions should the nurse take?
Administer IV hydrocortisone sodium
Give oral spironolactone
Infuse 1 unit of platelets
Restrict daily fluid intake
Administer IV hydrocortisone sodium - to replace the cortisol deficiency that is occuring
102
A nurse is monitoring the lab values of a client who has diabetes mellitus and is taking insulin. Which of the following results indicates a therapeutic outcome of insulin therapy?
Fasting blood glucose 96 mg/dL
Postprandial blood gluocse 195 mg/dL
Casual blood glucose 210 mg/dL
Preparandial blood glucose 60 mg/dL
Fasting blood glucose 96 mg/dL
103
A nurse is teaching a client who has type 1 diabetes mellitus about how to prevent complications during illness. Which of the following statements should the nurse identify as an indication the the client understands the teaching?
I should stop taking my insulin if I feel nauseous
I will test my urine for protein when I start to feel ill
I will call my doctor if my blood sugar is more than 250 milligrams per deciliter.
I should check my blood glucose level every 8 hours
I will call my doctor if my blood sugar is more than 250 milligrams per deciliter.
104
The client should check her urine for ketones when her blood glucose levels are greater than _____.
240 mg/dL
105
The client should check her blood glucose level every _____ during illness.
4 hours
106
The client should continue taking the usual dose of insulin, even when _____.
not feeling well
107
A nurse is teaching a client who has diabetes mellitus. Which of the following should the nurse include as an expected finding of diabetic ketoacidosis (DKA)?
Decreased urine output
Weight gain of 0.45 kg (1lb) in 24 hr
Rapid, shallow respirations
Blood glucose levels above 300 mg/dL
Blood glucose levels above 300 mg/dL.
Levels above 600 mg/dL are an expected finding with hyperglycemic-hyperosmolar state.
108
A nurse is preparing a teaching plan for a client who has diabetes insipidus and requires intranasal desmospressin. Which of the of following info should the nurse include in the teaching plan?
Drink at least 3 L of fluid per day
Weigh yourself weekly while wearing similar clothing at the same time of day
Notify the provider of a weight loss of 0.45 (1 lb) or more per week
Report nocturia because it requires a dosage adjustment
Report nocturia because it requires a dosage adjustment: the provider will increase the doasge until the client no longer has nocturia
109
A nurse is planning teaching for a client who has type 1 diabetes mellitus. Which of the following instructions should the nurse include?
Consume no more than 3 servings of alcohol per day
Ingest alcohol with food to reduce alcohol induced hypoglycemia
Increase insulin dosage before planned exercise
Rest for 3 days between periods of vigorous exercise
Ingest alcohol with food to reduce alcohol induced hypoglycemia - consuming carbs while drinking alcoholic beverages helps prevent hypoglycemia
110
The nurse should instruct the client with type 1 diabetes to _____ insulin dosage before planned exercise to prevent hypoglycemia.
reduce
111
The nurse should instruct the client with type 1 diabetes to exercise at least 3 times per week and have no more than ____ consecutive days without exercise.
2
112
A nurse is caring for a client who has type 2 diabetes mellitus and has hyperglycemic hyperosmolar state (HHS). Which of the following lab findings should the nurse expect?
serum pH of 7.32
blood glucose of 250 mg/dL
blood glucose of 425 mg/dL
serum pH of 7.45
serum pH of 7.45
HHS produces enough insulin to prevent ketosis, but not enough to prevent hyperglycemia. Glucose levels will be above 500 mg/dL
113
A nurse is teaching a client about glycosylated hemoglobin (HbA1c) testing. Which of the following statements should the nurse id as an indication that the client understands the information about this test?
I need to fast after midnight the night before the test
This test's result is a good indicator of my avg blood glucose levels
A level of 8 to 10 percent suggests adequate blood glucose control
I will use my hemoglobin A1c level to adjust my daily insulin doses
This test's result is a good indicator of my avg blood glucose levels
*HbA1c reflects the client's glucose levels over a 120 day period, which is the life span of RBCs.
114
The client should use ______ blood glucose levels to adjust daily insulin doses with the provider's approval.
capillary
115
Clients who have diabetes mellitus should keep their HbA1c below _____.
7%
116
The client does not need to fast before blood sampling for HbA1c. What the client eats the day _____ has no effect on the results of the test.
before
117
A nurse is an outpatient clinic is teaching a client who has a diabetic foot ulcer about foot care. Which of the following statements should the nurse id as an indication that the client understands the teaching?
I will let my feet air dry after washing.
I will wear sandals to allow air to circulate around my feet
I will buy OTC medicine to treat the calluses on my feet
I will apply lotion to the dry areas of my feet, but not between my toes
I will apply lotion to the dry areas of my feet, but not between my toes - this area is prone to bacterial growth
118
The client should wear _____ shoes to prevent injury to her feet.
closed toe shoes
119
A nurse has administered propranolol by IV bolus to a client who is having a thyroid storm. Which of the following findings indicates that the client is having a therapeutic response?
Reduction of the effects of thyroid hormone on the heart
Blockage of the release of thyroid hormone from the thyroid gland
Increase in the heart's sensitivity to thyroid hormone
Increase in the uptake of thyroid hormone by the thyroid gland
Reduction of the effects of thyroid hormone on the heart
**** decreases the rapid heart rate that excessive thyroid stimulation causes
120
A nurse is caring for a client undergoing screening for primary Cushing's disease. The nurse should expect an elevation in which of the following lab findings?
lympohoctye count
potassium
calcium
glucose
glucose
121
A nurse is admitting a client who has hyperthyrodism. When assessing the client, the nurse should expect which of the following findings?
cold intolerance
lethargy
tremors
sunken eyes
tremors
122
A nurse is assessing a client who has a new diagnosis of Cushing's disease. Which of the following findings should the nurse expect?
decreased bp
weight loss
hirsutism
increased skin thickness
Hirsutism
*** an expected finding of Cushing's disease due to increased androgen production
123
A nurse is caring for a client who has pehochromocytoma. Which of the following actions should the nurse take?
elevate the head of the client's bed
palpate the client's abdomen
monitor the client for hypotension
check the client's urine specific gravity
elevate the head of the client's bed - to reduce bp and abdominal pressure
124
The nurse should not ____ the abdomen of a client who has a pheochromocytoma b/c this can cause release of catecholamines and increased bp.
palpate
125
A nurse is caring for a client who has diabetes mellitus and has developed peripheral neuropathy. Which of the following measures should the nurse recommend to prevent injuries to the client's feet?
Examine the skin and feet weekly for alterations in skin integrity
Monitor the temp of bath water with a thermometer
Shop for shoes early in the day
Round the edges of toenails when trimming them
Monitor the temp of bath water with a thermometer
126
A nurse is reviewing lab values for a client who has DKA. Which of the following results should the nurse expect?
A. pH 7.32, PaCO2 36 mm Hg, HCO3 14
B. pH 7.38, PaCO2 55 mm Hg, HCO3 22
C. . pH 7.44, PaCO2 40 mm Hg, HCO3 24
D. pH 7.5, PaCO2 42 mm Hg, HCO3 30
A. pH 7.32, PaCO2 36 mm Hg, HCO3 14
Metabolic acidosis is a common manifestation of DKA, with pH characteristically low, CO2 w/in the expected reference range, and bicarbonate low.
127
Clients who have DKA have an _____ pH.
acidic
