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.
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Related Questions
Correct Answer is C
Explanation
A. Urine glucose monitoring is less accurate and not the priority in managing elevated blood glucose.
B. Oral hypoglycemics are not effective or recommended for type 1 diabetes because they do not replace insulin.
C. Elevated blood glucose in a client with type 1 diabetes post-surgery is typically managed by administering regular insulin doses as per sliding scale to maintain glycemic control.
D. Decreasing IV fluids is not indicated unless they contain glucose and are contributing to hyperglycemia; this decision depends on the fluid type and physician orders.
Correct Answer is A
Explanation
A. Insulin detemir is a long-acting insulin with an onset of action around 1 to 2 hours and a duration of 16 to 24 hours, depending on the dose and individual response.
B. Insulin glargine typically lasts close to 24 hours, but detemir may not last the full 24 hours in all clients.
C. This describes the action of short-acting insulin, not long-acting.
D. This is more consistent with intermediate-acting insulins like NPH, not long-acting types like detemir.
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