A nurse is teaching a client who has type 2 diabetes mellitus about a new prescription for glipizide. Which of the following instructions should the nurse include in the teaching?

"Monitor for manifestations of hypoglycemia."

"Take this medication at bedtime."

"Weigh yourself weekly to monitor for weight loss."

"Plan to continue to take over-the-counter medications as needed."

Answer and Explanation

The Correct Answer is A

A) "Monitor for manifestations of hypoglycemia":
Glipizide is a sulfonylurea, which works by increasing insulin secretion from the pancreas. This can lower blood glucose levels, potentially leading to hypoglycemia. Therefore, it's essential for the client to be aware of and monitor for symptoms such as sweating, shakiness, confusion, and dizziness to manage and treat hypoglycemia promptly.

B) "Take this medication at bedtime":
Glipizide is typically taken before meals to stimulate insulin secretion in response to food intake, helping control postprandial blood glucose levels. Taking it at bedtime is not recommended as it might not be as effective and could increase the risk of nighttime hypoglycemia.

C) "Weigh yourself weekly to monitor for weight loss":
While weight monitoring is important for managing diabetes, glipizide does not commonly cause weight loss. In fact, it may sometimes lead to weight gain. Therefore, this instruction is less relevant than monitoring for hypoglycemia.

D) "Plan to continue to take over-the-counter medications as needed":
Over-the-counter medications can interact with glipizide, potentially affecting blood glucose levels or increasing the risk of side effects. The client should consult with their healthcare provider before taking any new medications. This instruction does not address the primary concern of hypoglycemia management.

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Correct Answer is A

Explanation

A) Talk about the special features of the baby with the client: This intervention acknowledges the baby as a real person and can provide comfort to the grieving parents by validating their loss and giving them a chance to create memories, which is an important aspect of the grieving process.

B) Post a sign indicating No Visitors: This may not be appropriate as it might isolate the client further. Some parents may want the support of family and friends during this difficult time, and such a restriction should be based on the parents' wishes rather than a standard protocol.

C) Limit the amount of time the client is allowed to have the baby in her room: Allowing parents to spend as much time as they need with their baby can help them with the grieving process. Placing limits might be perceived as insensitive and could hinder the emotional healing process.

D) Tell the parents they should hold their baby: While many parents find comfort in holding their stillborn baby, it should be offered as a choice rather than a directive. It is important to respect the parents' individual coping mechanisms and provide support based on their preferences.

A. Maintain the client on bed rest for 48 hr following surgery. B. Check the tubing for kinks and blood clots at least every 2 hr. C. Irrigate the client's bladder continuously using 5% dextrose in Ringer's lactate. D. Remove the catheter if the client reports severe bladder spasms.

Correct Answer is B

Explanation

A) Maintain the client on bed rest for 48 hr following surgery: While some bed rest is recommended initially post-surgery, maintaining bed rest for 48 hours is excessive and can increase the risk of complications like deep vein thrombosis. Early mobilization is generally encouraged to enhance recovery.

B) Check the tubing for kinks and blood clots at least every 2 hr: Regularly checking the catheter tubing for kinks and blood clots is essential to ensure the continuous flow of urine and prevent catheter blockage. This can help in reducing the risk of complications such as bladder distension and urinary retention.

C) Irrigate the client's bladder continuously using 5% dextrose in Ringer's lactate: Continuous bladder irrigation is often done post-TURP to prevent clot formation, but 5% dextrose in Ringer's lactate is not the recommended solution. Typically, normal saline is used to minimize the risk of electrolyte imbalance and maintain the correct osmolarity.

D) Remove the catheter if the client reports severe bladder spasms: Severe bladder spasms can occur post-TURP, but removing the catheter is not the immediate solution. The catheter is necessary for drainage and should be managed with antispasmodic medications or adjusting the irrigation flow rather than removal.

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