A nurse in a provider's office is monitoring the laboratory results of a client who has type 1 diabetes mellitus.
Which of the following results indicates that the client demonstrates acceptable glycemic control?

Random plasma glucose 176 mg/dL.

Triglycerides 182 mg/dL.

HbA1c 6.8%.

Fasting blood glucose 120 mg/dL.

Answer and Explanation

The Correct Answer is C

Choice A rationale:

A random plasma glucose level of 176 mg/dL indicates high blood sugar at the time of the test. Random glucose levels are not ideal for assessing glycemic control as they can vary based on recent food intake and stressors.

Choice B rationale:

Triglyceride levels are not used to assess glycemic control. They measure the amount of triglycerides in the bloodstream and are related to lipid metabolism, not glucose control.

Choice C rationale:

HbA1c (glycated hemoglobin) is a long-term measure of blood glucose control. An HbA1c level of 6.8% indicates acceptable glycemic control in a person with diabetes. The normal range for HbA1c is typically less than 6.5%. This test reflects the average blood sugar level over the past 2-3 months, giving a better understanding of overall glucose control.

Choice D rationale:

Fasting blood glucose of 120 mg/dL is slightly elevated. While fasting blood glucose levels below 100 mg/dL are generally considered normal, levels between 100-125 mg/dL are considered prediabetic, and levels above 126 mg/dL on two separate occasions indicate diabetes. The result provided falls within the prediabetic range but does not indicate optimal glycemic control.

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Correct Answer is D

Explanation

Proceed with provision of medical care.

A. Contact the facility's ethics committee: This is incorrect because it is not an urgent action and it does not address the client's immediate needs. The ethics committee can be consulted later if there are ethical dilemmas or conflicts regarding the client's care.
B. Obtain consent from the client's employer: This is incorrect because it is not a valid source of consent. The employer has no legal or ethical authority to make decisions for the client, unless they are also a designated surrogate or proxy.
C. Limit care to comfort measures: This is incorrect because it does not meet the standard of care for an emergency situation. The nurse has a duty to provide life-saving interventions for a client who is unconscious and requires emergency medical procedures, unless there is evidence of a valid advance directive that states otherwise.
D. Proceed with provision of medical care: This is correct because it follows the principle of implied consent, which assumes that a reasonable person would consent to emergency treatment if they were able to do so. The nurse should document the circumstances and continue to search for family members or other sources of consent.

A. Providing postmortem care for a client who has recently died. B. Performing a simple dressing change on a client's foot. C. Washing hands with alcohol-based hand rub after bathing a client who has Clostridium difficile. D. Emptying an indwelling urinary catheter bag for a client while wearing clean gloves.

Correct Answer is C

Explanation

Choice A rationale:

Providing postmortem care for a client who has recently died does not require immediate intervention by the charge nurse, as it is a standard nursing responsibility to provide postmortem care with dignity and respect to the deceased client. The AP can proceed with this task independently.

Choice B rationale:

Performing a simple dressing change on a client's foot is within the scope of practice for an assistive personnel (AP) and does not require immediate intervention by the charge nurse, assuming the AP is competent and trained to perform this task.

Choice C rationale:

Washing hands with alcohol-based hand rub after bathing a client who has Clostridium difficile is not sufficient. Alcohol is not effective against C. Difficile spores.

Choice D rationale:

Clean gloves are sufficient for this task, as they do provide adequate protection against the transmission of infections.

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A nurse in a provider's office is monitoring the laboratory results of a client who has type 1 diabetes mellitus.Which of the following results indicates that the client demonstrates acceptable glycemic control?

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A nurse in a provider's office is monitoring the laboratory results of a client who has type 1 diabetes mellitus.
Which of the following results indicates that the client demonstrates acceptable glycemic control?