A patient in diabetic ketoacidosis is very lethargic and has a "funny" odor to his breath. The nurse would suspect this to be a result of
a. alcohol intoxication.
b. hyperglycemia.
c. hyperphosphatemia.
d. acetone.
D
Acid ketones dissociate and yield hydrogen ions (H+) that accumulate and precipitate a fall in serum pH. The level of serum bicarbonate also decreases consistent with a diagnosis of metabolic acidosis. Breathing becomes deep and rapid (Kussmaul respirations) to release carbonic acid in the form of carbon dioxide. Acetone is exhaled, giving the breath its characteristic "fruity" odor.
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A 16-year-old female presents at the emergency department complaining of right lower quadrant pain. She is diagnosed with appendicitis. When assessing this patient, what signs or symptoms should the nurse expect to find?
A) Rigid abdomen, Levine's sign, pain relief leaning forward B) Rebound tenderness, McBurney's sign, low-grade fever C) Right lower quadrant pain, Chvostek's sign, muscle guarding D) Periumbilical pain, Trousseau's sign, pain relief with pressure
The nurse is caring for a client who is depressed because of acute rejection following a kidney transplant. What is the nurse's best response?
a. "This is what happens when you don't take your transplant medications." b. "At least you can still have dialysis, unlike people who receive liver transplants." c. "One acute rejection episode does not mean that you will lose the new kidney." d. "You can always find another donor and get another kidney transplant."
A nursing student is presenting a discussion of the history of psychiatric–mental health nursing and its place within nursing history. Which of the following would be most appropriate to include?
A) Certification for the psychiatric–mental health nursing specialty was first emphasized by Mary Adelaide Nutting. B) Psychiatric nurses played a part in seeing that all deinstitutionalized patients got treatment at community mental health centers. C) There is a historical link between the first nursing program to admit male students and the first training school for psychiatric nursing. D) The first graduate program in psychiatric nurses was established in response to the publication of psychiatric nursing specialty journals.
The nurse is providing client teaching about the side effects of amitriptyline (Elavil). Which information should the nurse include in the teaching to promote prescription adherence?
A. Use ice chips to help alleviate dry mouth. B. Chew gum or use hard candy to help alleviate dry mouth. C. Avoid alcohol-based mouthwash to help alleviate dry mouth. D. Use "dry eye" drops to help with eye dryness. E. Request the pharmacist to fill the prescription from a different manufacturer.