A nurse is preparing a client for discharge who was admitted for diabetic ketoacidosis. Which of the following statements should the nurse include in the discharge teaching?
"If your breath smells fruity, decrease your oral intake.".
"If your blood sugar is greater than 300 milligrams per deciliter, check your urine for ketones.".
"Drink one liter of fluids daily.".
"When nausea is present, drink chilled water.".
The Correct Answer is B
Choice A rationale:
The nurse should not include the statement, "If your breath smells fruity, decrease your oral intake.”. in the discharge teaching for diabetic ketoacidosis. Fruity breath odor is a sign of diabetic ketoacidosis (DKA) due to ketone production. Decreasing oral intake would not address the underlying problem, and the client should be encouraged to seek medical attention promptly if experiencing this symptom.
Choice B rationale:
This is the correct choice. The nurse should instruct the client to check their urine for ketones if their blood sugar is greater than 300 milligrams per deciliter. High blood sugar levels can lead to ketone production, and monitoring ketones in the urine can help assess the severity of DKA and guide appropriate interventions.
Choice C rationale:
The statement, "Drink one liter of fluids daily.”. is not appropriate for a client with diabetic ketoacidosis. Clients with DKA often have fluid imbalances, and their fluid needs should be assessed and managed by healthcare professionals based on individual factors and laboratory values.
Choice D rationale:
The statement, "When nausea is present, drink chilled water.”. is not specific to diabetic ketoacidosis and may not be appropriate for all clients. Nausea can be caused by various factors, and addressing the underlying cause is important. Drinking chilled water may not necessarily alleviate nausea.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale:
Properly cutting the opening on the skin barrier wafer to fit over the stoma is crucial to prevent any irritation or damage to the surrounding skin. A well-fitted wafer creates a seal around the stoma, reducing the risk of stool coming into contact with the skin, which can cause excoriation.
Choice B rationale:
Emptying the bag when it is three-fourths full of stool is unrelated to the education on colostomy care. This information was provided in the previous question () and is not relevant to colostomy care education.
Choice C rationale:
The color of the stoma should not be slightly purple. A healthy stoma should be pink or red, indicating a good blood supply. A purple or dark-colored stoma could indicate inadequate blood flow, which is a concern and requires immediate medical attention.
Choice D rationale:
Cleansing the peristomal skin with moisturizing soap and water is not the recommended approach. The nurse should use plain water or mild, non-moisturizing soap to clean the peristomal skin, as moisturizing soap may leave a residue that affects the adhesion of the skin barrier wafer.
Correct Answer is C
Explanation
Choice A rationale:
Cauliflower is not a good dietary choice for a client with cholelithiasis. Cholelithiasis refers to the presence of gallstones, and certain foods, including cauliflower, can exacerbate symptoms in some individuals.
Choice B rationale:
Increasing the amount of egg yolks in the diet is not advisable for a client with cholelithiasis. Egg yolks are high in cholesterol and can contribute to gallstone formation.
Choice C rationale:
This is the correct choice. Desserts like angel-food cake are a better dietary option for a client with cholelithiasis. Angel-food cake is typically low in fat and cholesterol, making it a more suitable choice for those with gallbladder issues.
Choice D rationale:
Eating choice or prime cuts of meat is not recommended for clients with cholelithiasis. These types of meat are often higher in fat, which can trigger gallbladder symptoms.
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