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. Hypertension does not contraindicate the use of sulfonylureas.
B. A blood glucose level of 140 mg/dL is a common finding in type 2 diabetes, and sulfonylureas are used to control such levels.
C. Shingles (herpes zoster) does not directly contraindicate the use of sulfonylureas.
D. Sulfonylureas should not be given to patients with a sulfa allergy because these medications contain sulfa compounds, which could cause an allergic reaction.
Correct Answer is C
Explanation
Rationale:
A. A butterfly rash is associated with systemic lupus erythematosus (SLE), not Cushing's syndrome.
B. Muscle hypertrophy is not typically seen in Cushing's syndrome; instead, muscle wasting may occur due to excess cortisol.
C. Moon face is a classic sign of Cushing's syndrome, resulting from fat redistribution caused by elevated cortisol levels.
D. A positive Chvostek's sign indicates hypocalcemia, which is not a finding associated with Cushing's syndrome.