75. Management of a BUN of 71 and a creatinine of 2.7 in a client with diabetic ketoacidosis (DKA) is correctly accomplished with:
75. Management of a BUN of 71 and a creatinine of 2.7 in a client with diabetic ketoacidosis (DKA) is correctly accomplished with:
Test-Taking Tip
Remember that the client with DKA is severely dehydrated—flushed and warm. When two options are contradictory (Answers 1 and 2), often one of them is correct.
Content Area: Adult Health, Endocrine; Integrated Process: Nursing Process, Planning; Cognitive Level: Application; Client Need/Subneed: Physiological Integrity/Physiological Adaptation/Illness Management
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Answer 1 is correct because severe dehydration is often seen in DKA. This can decrease renal perfusion and cause buildup of BUN and creatinine. First, the client needs rehydration to correct prerenal failure. Then, an assessment can be made of renal function (which can be decreased in diabetes). Answer 2 is incorrect because fluid restriction would exacerbate the dehydration. Answer 3 is incorrect because dialysis is not required for creatinine levels of 2.7. Answer 4 is incorrect because a bladder catheter would not help manage the problem, only help assess the level of dehydration and the response to treatment with hourly urine output measurements.
