A nurse teaches a client who is diagnosed with diabetes mellitus. Which statement should the nurse include in this client's plan of care to delay the onset of microvascular and macrovascular complications?

Choice A rationale: The described symptoms—diaphoresis, palpitations, nervousness, and tachycardia—are classic signs of hypoglycemia, or low blood glucose. These symptoms are caused by the release of counter-regulatory hormones like epinephrine and cortisol. The first appropriate action is to check the blood glucose level to confirm hypoglycemia and then administer carbohydrates to rapidly raise it back to a safe range.
Choice B rationale: Giving nitroglycerin and performing an electrocardiogram are interventions for cardiac issues, such as angina or myocardial infarction. While palpitations and tachycardia are present, they are secondary to the hypoglycemia-induced stress response, not a primary cardiac event. Addressing the underlying hypoglycemia is the priority, as these cardiac symptoms are a direct physiological consequence of the low blood sugar.
Choice C rationale: Checking pulse oximetry and administering oxygen are interventions for respiratory compromise or hypoxemia. The client's symptoms are not indicative of an issue with oxygenation. Although the body is under stress, the primary problem is a metabolic imbalance, specifically low blood glucose. Providing oxygen would not correct the underlying physiological cause of the symptoms.
Choice D rationale: Restricting salt, administering diuretics, and performing paracentesis are treatments for fluid overload, ascites, and conditions like congestive heart failure or severe liver disease. The client's symptoms are not consistent with these conditions. These interventions would be inappropriate and could be harmful, as they do not address the metabolic derangement causing the hypoglycemia.

Choice A rationale: For a young adult with newly diagnosed type 1 diabetes mellitus, annual eye examinations by an ophthalmologist are recommended starting five years after the diagnosis. The risk of diabetic retinopathy, a microvascular complication, increases over time with chronic hyperglycemia. Therefore, maintaining a regular schedule for eye exams is crucial for early detection and management of vision changes.
Choice B rationale: This statement is incorrect as it suggests waiting for a vision problem to develop or until a later age. Regular, proactive screening is essential for managing diabetes. Diabetic retinopathy often progresses without noticeable symptoms in its early stages, so waiting for a change in vision can lead to delayed treatment and more significant damage.
Choice C rationale: This statement is inaccurate because while vision can be affected, it does not necessarily change quickly in the early stages. The recommendation for annual or even more frequent exams is based on the duration of diabetes and the presence of any complications, not an assumption of rapid change. For a newly diagnosed client, the standard is annual exams after a few years.
Choice D rationale: This statement is dangerously incorrect. Chronic hyperglycemia is a major risk factor for several eye diseases, including diabetic retinopathy, cataracts, and glaucoma. All clients with diabetes, regardless of age or how well-controlled their blood sugar is, are at risk for these complications and require regular, scheduled eye examinations to monitor for early signs of damage.