A nurse is providing teaching to a client who has type 1 diabetes mellitus. Which of the following statements by the client indicates an understanding of the teaching?

"I will have ketones in my urine if my blood glucose is maintained at 190 milligrams per deciliter."

"I will keep my blood glucose levels between 200 and 212 milligrams per deciliter."

"I will keep my HbA1c at five percent."

"Albumin in my urine is an indication of normal kidney function."

Answer and Explanation

The Correct Answer is A

In type 1 diabetes mellitus, when blood glucose levels are consistently high, the body may start breaking down fat for energy, leading to the production of ketones. Ketones can be detected in urine as a result. A blood glucose level of 190 milligrams per deciliter is elevated and can potentially trigger the production of ketones. Monitoring urine for ketones can be an important indicator of diabetes management and helps identify potential complications.
The other statements by the client indicate a lack of understanding or potential misconceptions:
●   "I will keep my blood glucose levels between 200 and 212 milligrams per deciliter": This statement suggests a target range that is higher than the recommended target blood glucose levels for individuals with diabetes. Generally, the target range for blood glucose levels in individuals with diabetes is lower, typically between 80-130 mg/dL before meals and below 180 mg/dL after meals.
●   "Albumin in my urine is an indication of normal kidney function": This statement is incorrect. The presence of albumin in the urine, called albuminuria, is an indication of kidney damage or dysfunction. It is a common sign of kidney disease, including diabetic nephropathy, which is a complication of diabetes affecting the kidneys.
●   "I will keep my HbA1c at five percent": While maintaining a lower HbA1c level is generally desirable for individuals with diabetes, a target of five percent is too low. HbA1c is a measure of average blood glucose levels over the past two to three months. The American Diabetes Association (ADA) recommends an HbA1c target of less than 7 percent for most adults with diabetes, although individualized targets may vary based on factors such as age and other health conditions.

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Correct Answer is A

Explanation

Hydrolyzed formulas are appropriate for clients who have inflammatory bowel disease. Hydrolyzed formulas are composed of partially or fully broken down nutrients that are easier to digest and absorb. They can also reduce inflammation in the intestinal lining, which can help with Crohn's disease symptoms.

High-fiber formulas are not recommended for clients who have inflammatory bowel disease, as they may worsen diarrhea, abdominal pain, and intestinal obstruction.

Low-protein formulas are also not suitable, as they may lead to protein malnutrition and impaired wound healing.

Low-calorie formulas are not indicated, as they may cause weight loss and increased disease activity.

A. "I will dilute juice with 50 percent water to supplement between feedings." B. "I should use pumped breast milk within 72 hours of refrigeration." C. "I will begin and end with the same breast when I feed my baby." D. "I should feed my baby on demand at least eight times each day."

Correct Answer is D

Explanation

"I should feed my baby on demand at least eight times each day": This statement is correct. Breastfed newborns should be fed on demand, following their cues of hunger. Newborns typically need to breastfeed at least eight times per day to ensure they receive enough nutrition and to establish and maintain a healthy milk supply for the mother.

"I will dilute juice with 50 percent water to supplement between feedings": This statement is incorrect. Breast milk or formula should be the sole source of nutrition for a newborn. Diluting juice with water is not recommended for newborns, as it does not provide the necessary nutrients and may fill the baby's stomach without providing adequate nutrition.

"I should use pumped breast milk within 72 hours of refrigeration": This statement is incorrect. Pumped breast milk can typically be stored in the refrigerator for up to 4-5 days, not just 72 hours. It is important for the mother to follow proper storage guidelines to ensure the safety and freshness of the breast milk.

"I will begin and end with the same breast when I feed my baby": This statement is incorrect. The breastfeeding technique known as "switch nursing" is often recommended, especially for newborns. Switch nursing involves offering both breasts during a feeding session to ensure the baby receives hindmilk, which is richer in fat and provides essential nutrients for growth.

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A nurse is providing teaching to a client who has type 1 diabetes mellitus. Which of the following statements by the client indicates an understanding of the teaching?

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