A nurse is providing education to a client who has type 1 diabetes mellitus and has been experiencing hypoglycemic episodes. Which of the following statements by the nurse is appropriate?

Keeping supplies on hand to treat hypoglycemic episodes is important.

Increasing exercise can help with hypoglycemia.

Clients with hypoglycemia cannot participate in religious/cultural fasting.

Clients will usually have obvious manifestations of hypoglycemia.

Answer and Explanation

The Correct Answer is A

Choice A reason:

Keeping supplies on hand to treat hypoglycemic episodes is crucial for clients with type 1 diabetes mellitus. Hypoglycemia, or low blood sugar, can occur suddenly and needs immediate treatment to prevent severe complications such as loss of consciousness or seizures. Supplies such as glucose tablets, juice, or candy can quickly raise blood sugar levels. The American Diabetes Association recommends that individuals with diabetes always carry a source of fast-acting carbohydrate to treat hypoglycemia. This proactive approach ensures that clients can manage their condition effectively and reduce the risk of severe hypoglycemic events.

Choice B reason:

Increasing exercise can help with hypoglycemia is not an appropriate statement. While regular exercise is beneficial for managing diabetes overall, it can actually increase the risk of hypoglycemia, especially if not properly managed. Exercise increases insulin sensitivity, which can lower blood glucose levels. Therefore, clients need to monitor their blood sugar levels before, during, and after exercise and adjust their carbohydrate intake or insulin dosage accordingly. Advising increased exercise without proper guidance on managing blood sugar levels can be dangerous for clients with type 1 diabetes.

Choice C reason:

Clients with hypoglycemia cannot participate in religious/cultural fasting is not entirely accurate. While fasting can pose challenges for individuals with diabetes, it is not impossible. Clients can participate in fasting with careful planning and medical supervision. They need to monitor their blood sugar levels more frequently and adjust their medication and food intake accordingly. Healthcare providers can work with clients to develop a plan that allows them to observe their religious or cultural practices safely. Therefore, a blanket statement that clients cannot participate in fasting is not appropriate.

Choice D reason:

Clients will usually have obvious manifestations of hypoglycemia is not always true. Hypoglycemia can present with a variety of symptoms, and not all clients will experience obvious signs. Common symptoms include shakiness, sweating, confusion, and irritability, but some individuals may have hypoglycemia unawareness, where they do not recognize the symptoms until their blood sugar levels are very low. This condition can be particularly dangerous as it increases the risk of severe hypoglycemia. Therefore, it is important for clients to regularly monitor their blood sugar levels rather than relying solely on symptoms.

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Correct Answer is A

Explanation

The correct answer is a) Serum potassium levels.

Choice A reason:

Serum potassium levels are crucial to monitor in clients with hypervolemia, ketoacidosis, and metabolic acidosis. Potassium imbalances are common in these conditions due to shifts between intracellular and extracellular compartments. In diabetic ketoacidosis (DKA), for example, insulin deficiency and acidosis cause potassium to move out of cells, leading to hyperkalemia. However, once treatment with insulin begins, potassium shifts back into cells, which can cause hypokalemia. Both hyperkalemia and hypokalemia can have serious cardiac implications, making it essential to monitor and manage potassium levels closely.

Choice B reason:

Serum calcium levels are important for overall health, but they are not the primary concern in the context of hypervolemia, ketoacidosis, and metabolic acidosis. While calcium imbalances can occur, they are less common and less immediately life-threatening compared to potassium imbalances. Monitoring calcium is still necessary, but it does not require the same level of immediate intervention.

Choice C reason:

Serum sodium levels are also important to monitor, especially in conditions like hypervolemia where fluid balance is disrupted. However, sodium imbalances are typically managed through fluid management and do not pose the same immediate risk as potassium imbalances in the context of ketoacidosis and metabolic acidosis. Hyponatremia or hypernatremia can cause neurological symptoms, but these are generally less acute compared to the cardiac risks associated with potassium imbalances.

Choice D reason:

Blood urea nitrogen (BUN) levels provide information about kidney function and hydration status. Elevated BUN can indicate dehydration or renal impairment, which are relevant in the context of hypervolemia and ketoacidosis. However, BUN levels do not require the same level of immediate intervention as potassium levels. Monitoring BUN is important for overall management but is not the primary concern in acute settings.

A. Synchronized electrical cardioversion B. Heart catheterization with percutaneous intervention C. Cardiac resynchronization therapy (CRT) D. Echocardiogram

Correct Answer is C

Explanation

Choice A reason: Synchronized Electrical Cardioversion

Synchronized electrical cardioversion is a procedure that uses a therapeutic dose of electric current to the heart at a specific moment in the cardiac cycle to restore a normal heart rhythm. It is typically used to treat certain types of arrhythmias, such as atrial fibrillation, atrial flutter, and supraventricular tachycardia. However, it is not the primary treatment for heart failure with arrhythmias. This procedure is more suited for acute management of arrhythmias rather than long-term regulation of heart rhythm in heart failure patients.

Choice B reason: Heart Catheterization with Percutaneous Intervention

Heart catheterization with percutaneous intervention, also known as percutaneous coronary intervention (PCI), involves using a catheter to open up blocked coronary arteries. This procedure is primarily used to treat coronary artery disease and improve blood flow to the heart muscle. While it can alleviate symptoms of heart disease and prevent heart attacks, it does not directly address the issue of arrhythmias associated with heart failure. Therefore, it is not the most appropriate choice for regulating heart rhythm in this context.

Choice C reason: Cardiac Resynchronization Therapy (CRT)

Cardiac resynchronization therapy (CRT) is a specialized treatment for heart failure patients who have developed arrhythmias. CRT involves implanting a device called a biventricular pacemaker, which sends electrical signals to both the left and right ventricles to help them contract in a more synchronized manner. This improves the efficiency of the heart’s pumping action and can significantly alleviate symptoms of heart failure, such as shortness of breath and fatigue. CRT is particularly beneficial for patients with moderate to severe heart failure and those whose heart chambers do not beat in unison. This makes CRT the most appropriate choice for regulating heart rhythm in a patient with worsening heart failure and arrhythmias.

Choice D reason: Echocardiogram

An echocardiogram is a diagnostic test that uses ultrasound waves to create images of the heart. It provides detailed information about the heart’s structure and function, including the size and shape of the heart chambers, the movement of the heart walls, and the function of the heart valves. While an echocardiogram is essential for diagnosing and monitoring heart conditions, it is not a treatment procedure. It does not regulate heart rhythm but rather helps in assessing the severity of heart failure and guiding treatment decisions.

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A nurse is providing education to a client who has type 1 diabetes mellitus and has been experiencing hypoglycemic episodes. Which of the following statements by the nurse is appropriate?

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