A nurse is caring for a client who is newly diagnosed with diabetes mellitus and is prescribed an 1800 calorie ADA diet. The client is refusing to eat the provided meals. Which of the following actions should the nurse take?

Offer the client's meals on a different schedule.

Discuss the client's food preferences with the hospital's dietitian.

Request the provider change the client's prescribed diet.

Allow the client's family to bring food from home for the client.

Answer and Explanation

The Correct Answer is B

A. Offer the client's meals on a different schedule. Changing the schedule may not address the core issue if the meals themselves do not align with the client’s preferences or cultural needs. It is not the most effective initial approach.
B. Discuss the client's food preferences with the hospital's dietitian. Collaborating with a dietitian allows for the modification of the meal plan to better align with the client’s preferences while still meeting nutritional and medical requirements. This supports client-centered care and improves adherence.
C. Request the provider change the client's prescribed diet. The provider may be involved later if significant changes are needed, but the dietitian is the appropriate first contact for customizing a prescribed diet based on individual preferences.
D. Allow the client's family to bring food from home for the client. While this can be an option, it must first be approved by the healthcare team to ensure the food aligns with the therapeutic diet and does not compromise the client’s condition.

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Correct Answer is B

Explanation

A. "Remain on bed rest for 24 hours following the procedure." Prolonged bed rest increases the risk of venous thromboembolism (VTE) and pulmonary complications. Early ambulation or movement is encouraged to promote circulation and prevent complications.
B. "Participate in range-of-motion exercises." Range-of-motion (ROM) exercises help stimulate venous return, improve circulation, and prevent blood stasis, which lowers the risk of postoperative blood clots and muscle stiffness.
C. "Place a pillow under your knees while in bed." Placing a pillow under the knees can impair circulation and increase the risk of venous stasis and thrombus formation. It is not recommended for circulation promotion.
D. "Use an incentive spirometer every 4 hours." While this instruction helps prevent respiratory complications, it is not a direct intervention for improving circulatory function. It's primarily used to promote lung expansion postoperatively.

A. Decrease the maintenance infusion rate of IV fluid. B. Have protamine sulfate available at the bedside. C. Reposition the client side-to-side each hour. D. Monitor the client for hypertension

Correct Answer is C

Explanation

A. Decrease the maintenance infusion rate of IV fluid. Epidural anesthesia can cause hypotension, so IV fluids are often used to help maintain blood pressure. Reducing the fluid rate may increase the risk of hypotensive episodes.
B. Have protamine sulfate available at the bedside. Protamine sulfate is the antidote for heparin, not relevant to epidural anesthesia. It is not required in the management of epidural-related side effects.
C. Reposition the client side-to-side each hour. Frequent repositioning helps prevent pressure injuries, promotes fetal oxygenation, and encourages effective labor progression. It also aids in the distribution of the anesthetic agent.
D. Monitor the client for hypertension. Hypotension, not hypertension, is a common adverse effect of epidural anesthesia due to vasodilation and decreased peripheral resistance. Blood pressure should be monitored closely for drops.

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A nurse is caring for a client who is newly diagnosed with diabetes mellitus and is prescribed an 1800 calorie ADA diet. The client is refusing to eat the provided meals. Which of the following actions should the nurse take?

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