A nurse is reviewing guidelines to prevent DKA during periods of illness with a client who has type 1 diabetes mellitus. Which of the following instructions should the nurse include in the teaching?
"Withhold your usual daily dose of insulin."
"Drink 240 to 360 milliliters of calorie-free liquids every 8 hours."
"Test your blood glucose level every 8 hours."
"Check your urine for ketones when blood glucose levels are greater than 240 mg/dL."
The Correct Answer is D
A. Incorrect. Withholding insulin during illness is not recommended. Clients with type 1 diabetes should continue to take their prescribed insulin even when they are ill. Insulin is necessary to regulate blood glucose levels, and illness can increase the body's demand for insulin.
B. Incorrect. Drinking calorie-free liquids is important to prevent dehydration during illness, but specific fluid amounts should be individualized based on the client's needs and healthcare provider's recommendations. The given volume is not a universally applicable guideline.
C. Incorrect. Testing blood glucose levels every 8 hours may not be frequent enough during illness. Blood glucose should be monitored more frequently to closely track changes in response to illness and adjust insulin doses accordingly.
D. Correct. Checking urine for ketones when blood glucose levels exceed 240 mg/dL is an important guideline during illness. Elevated blood glucose levels can lead to the production of ketones, and checking for ketones in the urine helps identify the early signs of diabetic ketoacidosis (DKA). If ketones are present, the client should follow a specific plan of action as outlined by their healthcare provider, which may include adjusting insulin doses or seeking medical attention.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. While a yearly dilated eye examination is crucial for the early detection and management of diabetic retinopathy, this action alone only addresses one of the two complications mentioned in the prompt. It does not prevent the development of nephropathy.
B. Examining the feet carefully every day is a vital preventive measure for diabetic neuropathy and peripheral vascular disease to avoid foot ulcers and infections. However, daily foot checks do not prevent microvascular damage to the eyes or kidneys.
C. Compression stockings are used to manage venous insufficiency or peripheral edema, but they are not standard preventative therapy for diabetic retinopathy or nephropathy, and tight hosiery may even be contraindicated if the client has co-existing peripheral arterial disease.
D. Maintaining stable, optimal blood glucose levels is the most effective primary intervention to prevent both retinopathy and nephropathy. Chronic hyperglycemia causes microvascular damage to the small blood vessels in both the retina and the renal glomeruli; therefore, strict glycemic control slows the onset and progression of both conditions simultaneously.
Correct Answer is C
Explanation
A. Incorrect. Aging is associated with a decrease in insulin production and a reduction in the speed of insulin release, not an increase.
B. Incorrect. Intolerance of fatty foods is not typically an age-related endocrine change. It may be related to other factors such as digestive issues.
C. Correct. Decreased sensitivity to insulin is a common age-related endocrine change, particularly in individuals with type 2 diabetes mellitus.
D. Incorrect. Lower and prolonged blood glucose levels are not an expected age-related endocrine change. Instead, insulin resistance tends to result in elevated blood glucose levels.
Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.
Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today
Report Wrong Answer on the Current Question
Do you disagree with the answer? If yes, what is your expected answer? Explain.
Kindly be descriptive with the issue you are facing.