A nurse is preparing discharge teaching for a type 1 diabetic patient who has been ill and unable to eat but continues insulin therapy.
Which instruction best reflects an advanced understanding of preventing complications during such periods of illness?
Stop insulin temporarily during illness to avoid hypoglycemia and rely on blood glucose monitoring for when to restart therapy.
Increase oral hypoglycemic medications during illness while reducing insulin doses, as oral agents are safer when the patient is not eating.
Adjust insulin dose according to blood glucose readings, maintain hydration with sugar-free fluids, and consume carbohydrate-containing liquids if unable to eat solid foods.
Continue to take prescribed insulin doses, monitor blood glucose every 3 to 4 hours, and consume sugar-free fluids regularly to maintain hydration.
The Correct Answer is C
This question addresses diabetes management during illness. It requires understanding the physiological stress response, which increases counter-regulatory hormones that cause hyperglycemia, and applying the "sick day rules" to adjust insulin and maintain hydration while preventing metabolic complications like ketoacidosis in Type 1 patients.
Choice A rationale
Stopping insulin during illness in a Type 1 diabetic is dangerous and leads to diabetic ketoacidosis. The body's metabolic demand for insulin often increases during stress and illness; therefore, insulin must always be continued to prevent critical, life-threatening metabolic derangement.
Choice B rationale
Oral hypoglycemic agents are ineffective for Type 1 diabetes because these patients do not have sufficient endogenous insulin production. Relying on oral agents during illness would lead to severe, uncontrolled hyperglycemia, which is the primary cause of diabetic ketoacidosis in this population.
Choice C rationale
During illness, Type 1 diabetics must continue insulin, monitor blood glucose frequently, and maintain hydration. If unable to eat solids, replacing carbohydrates with liquid equivalents ensures the insulin has fuel to manage, preventing hypoglycemia while maintaining adequate hydration and glycemic control.
Choice D rationale
While continuing insulin and monitoring glucose are correct, restricting fluids to sugar-free versions when the patient is not eating is insufficient. If the patient cannot consume carbohydrates, they need caloric intake to match their insulin and prevent dangerous hypoglycemia from occurring during illness.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
This question assesses the monitoring of HMG-CoA reductase inhibitors. It requires understanding the pharmacological goal of atorvastatin therapy, which is the reduction of atherogenic lipids in the blood to prevent long-term cardiovascular events and stabilize atherosclerotic plaques in patients at high risk.
Choice A rationale
High-density lipoprotein (HDL) is "good" cholesterol, with a normal range ≥ 40 mg/dL for men and ≥ 50 mg/dL for women. Atorvastatin therapy aims to increase or maintain HDL, so a decrease would indicate a non-therapeutic or adverse treatment outcome.
Choice B rationale
Low-density lipoprotein (LDL) is the primary target of atorvastatin. A therapeutic response is evidenced by a decrease in LDL levels, which should ideally be ≤ 100 mg/dL in high-risk patients, as LDL is directly linked to the development of atherosclerosis.
Choice C rationale
Total cholesterol, normal range ≤ 200 mg/dL, is a measure of various lipoproteins. Atorvastatin therapy is intended to lower total cholesterol. An increase in total cholesterol would suggest that the current dosage is ineffective at achieving the desired therapeutic lipid goals.
Choice D rationale
Triglycerides, normal range ≤ 150 mg/dL, are another component of the lipid panel. While some statins have a modest effect on triglycerides, the primary goal of atorvastatin is LDL reduction, and an increase would not indicate a positive therapeutic effect for the patient.
Correct Answer is ["1"]
Explanation
Step 1 is 330 mg ÷ 330 mg/mL = 1 mL. Final calculated answer is 1 mL.
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