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.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["B","C","D","E"]
Explanation
A. Incorrect. Sustaining hyperglycemia is not a recommended approach. In fact, it is crucial to maintain blood glucose levels within a target range to prevent complications associated with diabetes.
B. Correct. Maintaining optimal blood pressure is important for preventing kidney damage, which is a common complication of diabetes. High blood pressure can exacerbate kidney problems in individuals with diabetes.
C. Correct. Reducing cholesterol and saturated fat intake is important for managing cardiovascular risk factors associated with diabetes. Elevated cholesterol levels are a risk factor for heart disease, which is more prevalent in individuals with diabetes.
D. Correct. Enrolling in a smoking cessation program is essential. Smoking increases the risk of cardiovascular disease, which is already elevated in individuals with diabetes. Quitting smoking is a crucial step in reducing this risk.
E. Correct. Increasing physical activity is an important component of diabetes management. Regular exercise helps improve insulin sensitivity, maintain a healthy weight, and reduce the risk of cardiovascular complications.
Correct Answer is D
Explanation
A. NPH insulin: NPH insulin, also known as Neutral Protamine Hagedorn, is an intermediate acting insulin. It has a slower onset of action and a longer duration compared to regular insulin. It is not the best choice for treating diabetic ketoacidosis (DKA) because it does not act quickly enough to lower dangerously high blood glucose levels in this acute situation.
B. Insulin glargine: Insulin glargine is a long-acting basal insulin. It has a slow, steady release and provides a consistent level of insulin over an extended period. Like NPH insulin, it is not suitable for rapidly lowering blood glucose levels in a DKA emergency.
C. Insulin detemir: Insulin detemir is another long-acting basal insulin similar to glargine. It has a slow onset and provides a sustained release of insulin. It is not the first-line choice for treating DKA due to its slower action.
D. Regular Insulin: Regular insulin, also known as short-acting or fast-acting insulin, has a rapid onset of action. When administered intravenously, it can quickly lower blood glucose levels. This makes it the preferred choice for treating diabetic ketoacidosis (DKA) where prompt action is essential to correct the severe hyperglycemia and associated metabolic imbalances.
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