A nurse is planning discharge to home for a client who has a high risk of developing sepsis. Which of the following Instructions should the nurse include in the teaching?

Rationale:

• Change in weight: In uncontrolled diabetes due to the breakdown of fat and muscle when insulin is insufficient to utilize glucose effectively. Chronic pancreatitis can cause weight loss due to malabsorption of nutrients from pancreatic insufficiency and ongoing inflammation. Increased metabolic rate in hyperthyroidism causes the body to burn calories rapidly, often resulting in significant, unintentional weight loss.
• Blood glucose: A blood glucose level of 250 mg/dL is diagnostic of hyperglycemia and is strongly indicative of diabetes or poorly controlled blood glucose in a known diabetic. Inflammation of the pancreas can impair insulin production, leading to hyperglycemia, especially in chronic or severe pancreatitis.
• Current T3 level: A T3 level of 200 mg/dL is at the upper limit of normal. In the presence of other symptoms like weight loss and polyuria, it may support a diagnosis of hyperthyroidism or subclinical hyperthyroidism.
• Polyuria: High blood glucose levels exceed the renal threshold, leading to osmotic diuresis and frequent urination, a classic sign of diabetes. Increased metabolic activity and cardiac output in hyperthyroidism can lead to increased renal perfusion and mild diuresis, contributing to frequent urination.

• Administer an iron supplement: The client has lab findings and symptoms consistent with iron deficiency anemia, including low hemoglobin (8 g/dL), low hematocrit (24%), and low ferritin (8 ng/mL). An iron supplement is essential to correct the deficiency and restore adequate oxygen-carrying capacity in the blood.
• Restrict fluid intake: There is no evidence of fluid overload, hyponatremia, or heart failure in this client. Fluid restriction may worsen orthostatic hypotension by reducing circulating volume and is inappropriate in anemia and tachycardia.
• Place the client on a low sodium diet: The client’s blood pressure is within normal limits and there are no signs of hypertension or fluid retention. A low sodium diet may be beneficial in some chronic diseases, but it is not relevant or essential to this client’s current issues.
• Refer for a nutritional consult: The client follows a vegan diet and has both iron and borderline low vitamin B12 levels. A referral to a nutritionist will help ensure they are educated on how to meet their micronutrient needs, including iron and B12, through appropriate dietary sources and supplementation.