A nurse is preparing to discharge an obese client after abdominal surgery. Which instruction should the nurse prioritize to promote wound healing and prevent complications?

Choice A reason: A blood sugar of 50 mg/dL indicates hypoglycemia, not normal glucose levels (70-110 mg/dL). Symptoms like sweating and clamminess confirm this. Drinking water does not address hypoglycemia, as it lacks glucose to raise blood sugar, making this intervention inappropriate and potentially harmful.

Choice B reason: Hypoglycemia (50 mg/dL) with symptoms like sweating requires rapid glucose correction. Fruit juice with added sugar provides fast-acting carbohydrates (15-20g), raising blood sugar within minutes by stimulating glycogenolysis and glucose absorption. This is the most appropriate intervention to reverse hypoglycemia safely and effectively.

Choice C reason: Administering insulin during hypoglycemia (50 mg/dL) would further lower blood sugar, worsening symptoms and risking seizures or coma. Insulin drives glucose into cells, exacerbating the glucose deficit. This intervention is contraindicated and dangerous in the context of low blood sugar and neuroglycopenic symptoms.

Choice D reason: While consulting a healthcare provider may be needed for recurrent hypoglycemia, the immediate priority is correcting low blood sugar (50 mg/dL) with fast-acting carbohydrates. Delaying treatment by calling first risks prolonged hypoglycemia, potentially causing neurological damage, making this less appropriate than direct intervention.

Choice A reason: Crohn’s disease does not always spread to the liver. While it can cause liver complications like primary sclerosing cholangitis or fatty liver in some cases, this is not universal. This statement is inaccurate, as liver involvement is a complication, not a defining feature of Crohn’s disease.

Choice B reason: Crohn’s disease is characterized by a patchy, or “skip lesion,” pattern of bowel involvement, affecting any part of the gastrointestinal tract discontinuously. Inflammation is transmural, causing fistulas or strictures. This statement is accurate, as the patchy distribution is a hallmark distinguishing it from ulcerative colitis.

Choice C reason: Continuous bowel involvement is characteristic of ulcerative colitis, not Crohn’s disease. Crohn’s affects the bowel in a segmental, patchy manner, with healthy areas between lesions. This statement is inaccurate, as it incorrectly describes Crohn’s tissue involvement pattern, which is distinctly non-continuous.

Choice D reason: Crohn’s disease increases cardiovascular risk due to chronic inflammation, but stroke is not a well-established direct complication. Inflammatory markers may contribute to atherosclerosis, but stroke risk is less specific than patchy bowel involvement. This statement is inaccurate, as it overstates a specific stroke association.