A nurse reviews guidelines to prevent diabetic ketoacidosis (DKA) during periods of illness with a client with type 1 diabetes mellitus. Which of the following instructions should the nurse include in the teaching?
"Drink 240 to 360 milliliters of calorie-free liquids every 8 hours."
"Test your blood glucose level every 8 hours."
"Withhold your usual daily dose of insulin."
"Check your urine for ketones when blood glucose levels are greater than 240 mg/dL."
The Correct Answer is D
A. Clients should drink calorie-containing fluids to maintain energy and prevent hypoglycemia during illness, not just calorie-free liquids.
B. Blood glucose should be tested every 3 to 4 hours, not every 8 hours, during illness to detect hyperglycemia early.
C. Clients should continue their usual insulin dose even when ill to prevent DKA.
D. Clients should check urine for ketones when blood glucose levels exceed 240 mg/dL to detect early signs of ketoacidosis and seek prompt medical care.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. Dependent positioning can increase the risk of venous pooling and thrombosis.
B. Doppler ultrasound may be used if there is a suspicion of thrombosis but is not a standard preventative intervention.
C. Early ambulation and leg exercises promote circulation and reduce the risk of deep vein thrombosis, which is increased by oral contraceptive use.
D. Stopping oral contraceptives pre- or postoperatively is a physician’s decision, not a nursing intervention.
Correct Answer is D
Explanation
A. Fatigue and restlessness may be early signs but are less specific.
B. Elevated blood pressure is not a primary sign of hyponatremia.
C. Shortness of breath is not directly related to hyponatremia.
D. Altered mental status indicates worsening hyponatremia and possible cerebral edema, requiring urgent attention.
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