A nurse provides discharge teaching to a patient newly diagnosed with type 2 diabetes mellitus. Which of the following patient statements demonstrate accurate understanding of disease management? (SELECT ALL THAT APPLY)

Rationale:
A. This is correct understanding. Glyburide, a sulfonylurea, can interact with alcohol to cause severe hypoglycemia or a disulfiram-like reaction. Complete avoidance of alcohol is recommended, so this statement shows proper comprehension.

B. Alcohol can enhance the hypoglycemic effects of glyburide, leading to symptoms such as dizziness, lightheadedness, or fainting. The client recognizing this risk demonstrates understanding of medication-alcohol interactions.

C. Alcohol can potentiate the blood-glucose-lowering effects of glyburide by inhibiting gluconeogenesis, increasing the risk of hypoglycemia. This statement shows the client understands the potential danger.

D. Even small amounts of alcohol can precipitate hypoglycemia in clients taking glyburide, particularly if alcohol is consumed without food. This statement indicates a misunderstanding of the risks, so the nurse should provide further teaching to emphasize complete avoidance of alcohol while on sulfonylureas.

Rationale:

A. While padding bed rails can reduce injury if a fall occurs, it does not actively prevent the patient from attempting to get out of bed or losing balance. It is a passive safety measure, not a primary fall-prevention strategy.

B. Physical restraints are not recommended for fall prevention due to the risk of injury, immobility, and psychological harm. Restraints may actually increase fall risk if patients struggle against them, and their use is regulated and reserved for emergency situations only.

C. Bed or chair alarms alert staff immediately when a high fall-risk patient attempts to get up unassisted, allowing timely intervention to prevent falls. This is an active safety measure that is evidence-based for patients with impaired mobility, weakness, or poor coordination, as often seen in MS exacerbations. Alarms support early recognition of risk behaviors while promoting patient independence.

D. Prolonged bed rest is not recommended because it can lead to deconditioning, muscle weakness, and further mobility deficits, which may increase fall risk over time. MS patients benefit from supervised mobility and activity as tolerated, combined with safety measures.