A nurse is providing discharge teaching for a client who has hyperosmolar hyperglycemic syndrome (HHS). Which of the following topics should be prioritized for teaching?

Decreasing smoking

Increasing fluid intake

Increasing daily exercise

Decreasing intake of red meat

Answer and Explanation

The Correct Answer is B

A. Decreasing smoking: While smoking cessation is important for general health, it is not directly related to the prevention or management of HHS. Addressing dehydration and glucose control takes precedence in the acute management and prevention of recurrence.
B. Increasing fluid intake: Adequate hydration is the most critical aspect of preventing HHS, as dehydration is a key precipitating factor. Clients with HHS experience significant fluid loss, and increasing fluid intake helps maintain circulatory volume and reduce blood glucose concentration.
C. Increasing daily exercise: Although regular exercise helps with long-term diabetes control, it must be approached cautiously in clients recovering from HHS. Excessive or poorly timed physical activity could exacerbate glucose fluctuations if not coordinated with meals and insulin.
D. Decreasing intake of red meat: Diet modifications may help in overall health, but red meat intake is not directly linked to HHS prevention. The immediate concern is managing hydration and glucose levels to prevent another crisis.

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Correct Answer is A

Explanation

A. MS hug: The "MS hug" refers to a tight or squeezing sensation around the torso, often caused by muscle spasms or spasticity in multiple sclerosis (MS). This is a common symptom in MS and can feel like pressure or a tight band around the chest or abdomen.
B. Paroxysmal spasms: Paroxysmal spasms are sudden, short episodes of intense muscle contractions. While these spasms may occur in MS, the sensation described in the question is more specific to the MS hug, which involves a sensation of tightness rather than spasm.
C. Lhermitte's sign: Lhermitte's sign is a sudden, electric shock-like feeling that runs down the spine or limbs when the neck is flexed. This sign is common in individuals with multiple sclerosis but does not describe the tightening sensation around the torso.
D. Trigeminal neuralgia: Trigeminal neuralgia causes severe facial pain due to irritation of the trigeminal nerve, not a tightening sensation around the torso. It typically presents as sharp, stabbing pain along the facial nerve distribution.

A. The client admitted to the hospital who has clinical findings of severe flank pain, nausea, and vomiting. B. The client admitted to the hospital who has clinical findings of polyuria, nocturia, proteinuria, and a palpable kidney mass. C. The client admitted to the hospital who has clinical findings of urinary urgency, weak urine stream, and dysuria. D. The client admitted to the hospital who has clinical findings of periorbital edema, dark frothy urine, and elevated blood pressure.

Correct Answer is A

Explanation

A. The client admitted to the hospital who has clinical findings of severe flank pain, nausea, and vomiting: These are hallmark signs of a current or recent episode of kidney stones. Once the acute symptoms are managed, this client would benefit the most from kidney stone prevention education, including dietary modifications and increased fluid intake, to reduce recurrence risk.
B. The client admitted to the hospital who has clinical findings of polyuria, nocturia, proteinuria, and a palpable kidney mass: These signs suggest a chronic kidney condition such as polycystic kidney disease or another form of kidney pathology rather than nephrolithiasis. Kidney stone prevention is not the primary teaching focus for this client.
C. The client admitted to the hospital who has clinical findings of urinary urgency, weak urine stream, and dysuria: These symptoms are more consistent with a lower urinary tract condition such as benign prostatic hyperplasia (BPH) or a urinary tract infection, rather than kidney stones. Prevention teaching should be focused on the underlying cause.
D. The client admitted to the hospital who has clinical findings of periorbital edema, dark frothy urine, and elevated blood pressure: These symptoms point to nephrotic syndrome or glomerulonephritis, which involve protein loss and renal inflammation. The pathophysiology here differs from that of kidney stone formation, and stone prevention would not be the priority.

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A nurse is providing discharge teaching for a client who has hyperosmolar hyperglycemic syndrome (HHS). Which of the following topics should be prioritized for teaching?

Nursing Test Bank

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