A client with diabetes mellitus is admitted with an infected foot pressure injury. During a routine assessment, the practical nurse (PN) notes a pattern of deep, rapid respirations and a fruity breath odor. Which action should the PN take first?

Choice A reason: Applying direct pressure over the area that is bleeding is a general first aid measure to stop bleeding. However, in the context of obtaining a fingerstick blood sugar, this action is not the immediate next step. The objective of the fingerstick is to obtain a sample of blood for testing blood glucose levels. Applying pressure would stop the flow of blood, making it difficult to obtain a sufficient sample for the test.
Choice B reason: Wiping off the drop of blood with a gauze pad is not recommended after pricking the finger for a blood glucose test. Removing the initial drop of blood could result in the need to squeeze the finger again, potentially causing hemolysis (breaking of blood cells) and leading to an inaccurate reading. It is important to use the initial drop of blood for the test to ensure accurate results.
Choice C reason: Cleaning the finger with an alcohol prep pad before pricking is a standard step to ensure that the area is free from contaminants and to prevent infection. However, doing this after the drop of blood is visible is unnecessary and can interfere with the sample. Alcohol residue can affect the accuracy of the blood glucose reading. Therefore, cleaning should be done prior to pricking, not after the blood is obtained.
Choice D reason: Applying the drop of blood to the test strip is the correct action to take. Once the drop of blood is visible, it should be applied to the test strip immediately to obtain a blood glucose reading. This ensures that the sample is fresh and uncontaminated, providing an accurate measurement of the client's blood sugar levels. This step is essential for effective monitoring and management of diabetes.

Choice A reason: Aldosterone is a hormone produced by the adrenal cortex that helps regulate sodium and potassium levels in the body. While aldosterone levels can indicate adrenal function, they are not as commonly used as cortisol levels in diagnosing adrenal cortex failure. Aldosterone regulation is also influenced by the renin-angiotensin-aldosterone system, making it a less direct indicator of overall adrenal cortex function compared to cortisol.
Choice B reason: Cortisol is a glucocorticoid hormone produced by the adrenal cortex and plays a vital role in regulating metabolism, immune response, and stress. Measuring cortisol levels is a primary method for assessing adrenal cortex function. Low cortisol levels can indicate adrenal insufficiency or failure, such as in conditions like Addison's disease. Evaluating cortisol levels provides a direct assessment of the adrenal gland’s ability to produce essential hormones necessary for the body's normal functioning.
Choice C reason: Thyroxine (T4) is a hormone produced by the thyroid gland, not the adrenal cortex. It plays a crucial role in regulating metabolism, growth, and development. While thyroxine levels are important for thyroid function assessment, they do not directly reflect the functioning of the adrenal gland. Therefore, thyroxine levels are not relevant in diagnosing adrenal cortex failure.
Choice D reason: Insulin is a hormone produced by the pancreas and is essential for regulating blood glucose levels. It is not related to the adrenal cortex. Monitoring insulin levels is important for diagnosing and managing diabetes mellitus but does not provide information about the functioning of the adrenal gland. Insulin levels are not used to assess adrenal cortex function.