During the 0700 beginning of the shift assessment, the nurse finds a client who was diagnosed with type I diabetes mellitus to be difficult to arouse. Per unit protocol, arterial blood gases and a blood glucose are performed. The results show pH 7.01, PO₂ 92, PCO₂ 36, HCO₃ 9, blood glucose 873. What action should the nurse take first? A)Administer the client's 0800 dose of NPH insulin immediately. B)Notify the physician and the house supervisor of the client's condition. C)Begin an IV line with 0.5% normal saline and prepare sodium bicarbonate for administration. D)Attempt to arouse the client and determine what he ate the previous evening to raise his blood glucose.

Question

Quizplus · Accepted Answer

The client's acidosis and high blood glucose levels indicate a medical emergency known as diabetic ketoacidosis (DKA). The first priority is to establish an IV line with 0.5% normal saline to prevent dehydration and administer sodium bicarbonate to correct the acidosis. The physician and house supervisor should also be notified immediately, but this should occur after starting IV fluids and administering sodium bicarbonate. Administering NPH insulin or attempting to determine the cause of the high blood glucose level can wait until the client's immediate medical needs are addressed.

During the 0700 Beginning of the Shift Assessment, the Nurse