Select N Set 5: Endocrine & Diabetes (NCLEX)

The nurse in the emergency department is caring for a 19-year-old female client.

1330:History of type 1 diabetes. Reports 2 days of vomiting and extreme thirst. Deep, rapid respirations with a fruity breath odor. Mucous membranes dry. Alert and oriented.

1340:Primary health care provider (PHCP) at bedside; treatment for diabetic ketoacidosis (DKA) prescribed.

The nurse has reviewed the Laboratory Results from 1330 and the Orders from 1340.

Select the 3 actions the nurse should implement first.

1.Initiate continuous cardiac monitoring.
2.Infuse 0.9% sodium chloride 1,000 mL IV over 1 hour.
3.Administer insulin glargine 20 units subcutaneously.
4.Start the regular insulin infusion at 0.1 units/kg/h.
5.Infuse potassium chloride 10 mEq/h IV by infusion pump.
6.Change the IV fluid to dextrose 5% in 0.45% sodium chloride.