A nurse is providing discharge instructions to a patient about self-administration of regular insulin. Which of the following instructions should be included by the nurse?

Choice A rationale

It is important for a client with diabetes mellitus to test the temperature of the water before bathing to prevent burns. People with diabetes often have neuropathy, which can reduce their ability to feel temperature changes, especially in their extremities. Therefore, using the wrist, which is more sensitive to temperature changes, can help ensure the water is not too hot.

Choice B rationale

Applying a heating pad to the feet is not recommended for people with diabetes. This is because the heat can cause burns, especially in those with neuropathy who may not be able to feel how hot the pad is.

Choice C rationale

Rounding the corners of toenails with a nail file is not recommended as it can lead to ingrown toenails. Instead, toenails should be cut straight across to avoid this.

Choice D rationale

While it’s important to keep skin moisturized to prevent dryness and cracking, lotion should not be applied between the toes. This area can stay moist and warm, creating an ideal environment for fungal infections.

Comparing the current blood pressure reading to the preoperative value is the first step the nurse should take. This will help determine if the patient’s blood pressure has significantly dropped, which could indicate hypovolemia or shock.

Choice B rationale

Covering the patient with a warm blanket may be helpful if the patient is feeling cold or showing signs of hypothermia, but it would not address the underlying cause of the low blood pressure.

Choice C rationale

Increasing the IV flow rate might be necessary if the patient is hypovolemic, but this decision should be based on additional assessment data and physician orders.

Choice D rationale

Reassuring the patient is important, but it should not be the first action. The nurse needs to assess and address the cause of the low blood pressure.