A nurse in a provider’s office is collecting data from an older adult client who has type 2 diabetes mellitus. Which of the following findings is a manifestation of hyperglycemia?

Choice A Reason:

Administering intravenous acetazolamide is a critical intervention for acute narrow-angle glaucoma. Acetazolamide is a carbonic anhydrase inhibitor that reduces the production of aqueous humor, thereby lowering intraocular pressure (IOP) quickly. Reducing IOP is essential to prevent optic nerve damage and preserve vision. Normal IOP ranges from 10 to 21 mmHg, and in acute narrow-angle glaucoma, it can exceed 30 mmHg. Rapid reduction of IOP is crucial to alleviate symptoms and prevent further complications.

Choice B Reason:

Applying warm compresses to the affected eye is not an appropriate intervention for acute narrow-angle glaucoma. Warm compresses may provide temporary relief for some eye conditions, but they do not address the underlying issue of elevated intraocular pressure. In fact, warm compresses can potentially increase blood flow to the eye, which might exacerbate the condition.

Choice C Reason:

Encouraging the patient to drink plenty of fluids to stay hydrated is generally good advice for overall health, but it is not a prioritized intervention for acute narrow-angle glaucoma. Hydration does not directly impact intraocular pressure or alleviate the acute symptoms of glaucoma. The primary focus should be on reducing IOP to prevent optic nerve damage.

Choice D Reason:

Administering a mydriatic agent to dilate the pupil is contraindicated in acute narrow-angle glaucoma. Mydriatic agents can worsen the condition by further narrowing the anterior chamber angle, increasing intraocular pressure, and potentially causing more damage to the optic nerve. It is crucial to avoid pupil dilation in this scenario.

Choice A Reason:

A random blood glucose level of 126 mg/dL is not typically indicative of hyperglycemia. Hyperglycemia is generally defined as a blood glucose level above 180 mg/dL. A level of 126 mg/dL is closer to the threshold for diagnosing diabetes but does not necessarily indicate hyperglycemia.

Choice B Reason:

A history of poor wound healing is a common manifestation of hyperglycemia. High blood sugar levels can impair the body’s ability to heal wounds by affecting blood flow and the function of immune cells. This can lead to prolonged wound healing times and an increased risk of infections.

Choice C Reason:

Decreased urinary output is not a typical symptom of hyperglycemia. In fact, hyperglycemia often causes increased urinary output (polyuria) due to the body’s attempt to excrete excess glucose through urine. Decreased urinary output could be indicative of other conditions, such as dehydration or kidney issues.

Choice D Reason:

Clammy skin is more commonly associated with hypoglycemia (low blood sugar) rather than hyperglycemia. Hypoglycemia can cause symptoms such as sweating, shakiness, and clammy skin due to the body’s response to low blood sugar levels. Hyperglycemia, on the other hand, does not typically cause clammy skin.