Page 279 - Saunders Comprehensive Review For NCLEX-RN

E. Interventions in diabetes mellitus and diabetic

ketoacidosis
1. Give insulin as prescribed to hasten the movement of
glucose into the cells, thereby decreasing the
concurrent ketosis.
2. When glucose is being properly metabolized, the body
will stop converting fats to glucose.
3. Monitor for circulatory collapse caused by polyuria,
which may result from the hyperglycemic state;
osmotic diuresis may lead to extracellular volume
deficit.

Monitor the client experiencing severe diarrhea for

manifestations of metabolic acidosis.
F. Interventions in kidney disease
1. Dialysis may be necessary to remove protein and
waste products, thereby lessening the acidotic state.
2. A diet low in protein and high in calories decreases
the amount of protein waste products, which in turn
lessens the acidosis.
VI. Metabolic Alkalosis
A. Description: A deficit of carbonic acid and a decrease in hydrogen
ion concentration that results from the accumulation of base or
from a loss of acid without a comparable loss of base in the body
fluids.
B. Causes: Metabolic alkalosis results from a dysfunction of

metabolism that causes an increased amount of available base
solution in the blood or a decrease in available acids in the blood
(Box 9-4).

C. Assessment (see Table 9-2)

Monitor the client experiencing excessive vomiting or the client with

gastrointestinal suctioning for manifestations of metabolic alkalosis.
D. Interventions
1. Monitor for signs of respiratory distress.
2. Prepare to administer medications and intravenous
fluids as prescribed to promote the kidney excretion
of bicarbonate.
3. Prepare to replace potassium as prescribed.

VII. Arterial Blood Gases (ABGs) (Table 9-3)

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