A client with type 1 diabetes mellitus and peripheral neuropathy is seeing the nurse to review foot care. What would be a priority instruction for the nurse to give the client?

A. Development of a buffalo hump and moon face:
This is associated with Cushing's syndrome, a disorder characterized by prolonged exposure to high levels of cortisol.

B. Central obesity and purple striations:
Also indicative of Cushing's syndrome, where excess cortisol can lead to the accumulation of fat in the abdominal area (central obesity) and the development of purple stretch marks (striae).

C. Sudden weight loss without dieting:
This is more characteristic of hyperthyroidism, where the thyroid gland is overactive, leading to increased metabolism and unintended weight loss.

D. Positive Trousseau's sign when checking the client's blood pressure:
Trousseau's sign is associated with hypocalcemia and is seen in conditions affecting the parathyroid gland rather than the thyroid. It involves carpal spasm induced by inflating a blood pressure cuff above the systolic pressure for a few minutes.

A. Stress has likely caused an increase in the client's blood sugar levels:
This statement is accurate. Stress, especially related to surgery, can lead to increased levels of stress hormones, such as cortisol and catecholamines, which can elevate blood sugar levels. Surgery is a physiological stressor that can impact glucose metabolism.

B. The client's volatile fluid balance surrounding surgery has likely caused unstable blood sugars:
This is the most appropriate choice. Surgery, anesthesia, and changes in fluid balance can affect blood glucose levels. The stress response to surgery can lead to fluctuations in blood sugar, and patients may need insulin during this period.

C. The client has likely overstimulated her ability to control her diabetes using non-pharmacologic measures:
This statement is not accurate. Overstimulation is not a common cause of the need for insulin in the context of surgery. The stress and physiological changes associated with surgery are more likely contributors.

D. Alterations in bile metabolism and release have likely caused hyperglycemia:
While alterations in metabolism can impact glucose regulation, in the context of surgery, the primary factors are the stress response, changes in fluid balance, and potential alterations in the ability to eat or drink normally rather than specific effects on bile metabolism.