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."

Answer and Explanation

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.

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Correct Answer is B

Explanation

A. Obtaining a culture of the drainage may be necessary, but the immediate concern is to determine if the drainage is cerebrospinal fluid (CSF) or another type of fluid. Checking for glucose content is a rapid way to differentiate CSF from other fluids.

B. Correct. Clear drainage from the nose post-transsphenoidal hypophysectomy may indicate a CSF leak, which is a potential complication. Checking the drainage for glucose can help differentiate CSF from other fluids, as CSF contains glucose. If the drainage tests positive for glucose, it indicates the presence of CSF.

C. Documenting the amount of drainage is important, but determining the nature of the drainage (CSF or other fluid) takes precedence in this situation.

D. Notifying the client's provider is important, but the nurse should gather information about the drainage first by checking for glucose content. This information will be crucial for the healthcare provider to make decisions about further interventions

A. Administer aspirin as prescribed for any sign of hyperthermia. B. Keep the client NPO. C. Observe the client carefully for signs of hypocalcemia. D. Provide a quiet, low-stimulus environment.

Correct Answer is D

Explanation

A. Administering aspirin for hyperthermia is not a standard intervention for hyperthyroidism. Hyperthermia can occur in severe cases of hyperthyroidism, but the primary intervention is to address the underlying thyroid dysfunction and provide supportive care.

B. Keeping the client NPO (nothing by mouth) is not directly related to preventing a thyroid crisis in hyperthyroidism. It may be necessary for certain pre-operative preparations or if the client is undergoing specific procedures, but it does not address the prevention of a thyroid crisis.

C. While monitoring for signs of hypocalcemia is important in some cases of thyroid dysfunction, it is not the primary action to prevent a thyroid crisis. In hyperthyroidism, the focus is on managing excessive thyroid hormone levels.

D. Correct. Providing a quiet, low-stimulus environment is a crucial nursing intervention for clients with hyperthyroidism. They can be highly sensitive to external stimuli due to their increased metabolic rate. A calm environment helps reduce stress and the risk of exacerbating symptoms, potentially preventing a thyroid crisis.

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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?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who is 1 day postoperative following a transsphenoidal hypophysectomy. While assessing the client, the nurse notes a large area of clear drainage seeping from the nasal packing. Which of the following should be the nurse's initial action?

Correct Answer is B

Explanation

Correct Answer is D

Explanation

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