A patient has been admitted to the hospital with the diagnosis of DKA. What vital signs should a nurse anticipate that the patient will exhibit?
Temperature, 98° F; pulse, 84 beats/min; respirations, 18 breaths/min and shallow
Temperature, 99° F; pulse, 62 beats/min; respirations, 16 breaths/min and shallow
Temperature, 97.4° F; pulse, 110 beats/min; respirations, 26 breaths/min and deep
Temperature, 98.6° F; pulse, 76 beats/min; respirations, 16 breaths/min and deep
The Correct Answer is C
Rationale:
A. Normal pulse and respiratory rates do not indicate the expected tachycardia or Kussmaul respirations in DKA.
B. This option shows a slower heart rate, which is not typical of DKA where tachycardia is expected.
C. In diabetic ketoacidosis (DKA), clients typically exhibit tachycardia due to dehydration and deep, rapid Kussmaul respirations as the body attempts to correct the acidosis.
D. The vital signs in this option do not reflect the expected findings of DKA, such as tachycardia and deep respirations.
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Correct Answer is D
Explanation
Rationale:
A. Dorsal recumbent is not an ideal position after a thyroidectomy due to the risk of airway obstruction.
B. Supine position does not provide optimal airway protection post-surgery.
C. Sims' position is not recommended for clients recovering from a thyroidectomy as it could affect breathing and circulation.
D. Fowler’s position (head of the bed elevated 45 to 90 degrees) is the best position post-thyroidectomy to reduce tension on the suture line and to facilitate breathing by decreasing swelling around the surgical site.
Correct Answer is D
Explanation
Rationale:
A. Abruptly withdrawing corticosteroid therapy can lead to adrenal insufficiency, not Cushing syndrome.
B. Poorly functioning adrenal glands cause Addison’s disease, not Cushing syndrome.
C. Lacking ACTH leads to secondary adrenal insufficiency, not Cushing syndrome.
D. Taking corticosteroids for many years can result in exogenous Cushing syndrome due to prolonged exposure to high cortisol levels, which mimic the effects of endogenous Cushing syndrome.