A patient diagnosed with Type 1 diabetes reports a blood glucose level of 210 mg/dL and symptoms of a sore throat, cough, and fever.
What advice should the nurse give to the patient?
Limit intake to non-caloric containing liquids until the glucose is within normal limits.
Decrease intake of carbohydrates until blood glucose level is less than 100 mg/dL.
Monitor blood glucose levels every 4 hours and notify the doctor if it continues to rise.
Only administer the morning prescribed dose of insulin.
The Correct Answer is C
Choice A rationale
Limiting intake to non-caloric containing liquids until the glucose is within normal limits is not the best advice for a patient with Type 1 diabetes reporting a blood glucose level of 210 mg/dL and symptoms of a sore throat, cough, and fever. While it’s important to stay hydrated, especially when sick, it’s also crucial to maintain a balanced diet to provide the body with necessary nutrients for recovery.
Choice B rationale
Decreasing intake of carbohydrates until blood glucose level is less than 100 mg/dL is not recommended. Carbohydrates are a primary source of energy, and reducing their intake could lead to low blood sugar or hypoglycemia, which can be dangerous.
Choice C rationale
Monitoring blood glucose levels every 4 hours and notifying the doctor if it continues to rise is the best advice. When a patient with diabetes is sick, their blood glucose levels can rise due to the stress the body is under. Regular monitoring allows for timely adjustments in insulin dosage and helps prevent diabetic ketoacidosis, a serious complication.
Choice D rationale
Administering only the morning prescribed dose of insulin is not advisable. Insulin requirements can increase when a person with diabetes is sick. Therefore, sticking to the regular insulin regimen without adjustments could lead to high blood sugar or hyperglycemia.
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Related Questions
Correct Answer is A
Explanation
Choice A rationale
Acarbose and repaglinide are medications used to manage blood glucose levels in people with type 2 diabetes. Acarbose slows the digestion of carbohydrates in the gut, which helps to prevent spikes in blood glucose after meals. Repaglinide stimulates the pancreas to release more insulin. Both of these medications can cause hypoglycemia, or low blood sugar.
Therefore, carrying glucose tablets or gels is a good practice because they can quickly raise blood sugar levels during an episode of hypoglycemia.
Choice B rationale
Taking these medications on an empty stomach is not recommended. Acarbose should be taken with the first bite of each main meal. Repaglinide should be taken within 30 minutes before meals. Therefore, this statement does not indicate effective teaching.
Choice C rationale
Drinking orange soda to treat symptoms of hypoglycemia is not the best choice. While orange soda can increase blood sugar levels, it also contains other ingredients, like caffeine, that are not beneficial for people with diabetes. Glucose tablets or gels are a better option because they provide a fast-acting source of glucose and are easy to dose.
Choice D rationale
This statement is incorrect. While repaglinide does stimulate the pancreas to release more insulin, it does not mean that the person has to start taking insulin shots. Acarbose works by slowing the digestion of carbohydrates in the gut, not by affecting insulin release. Therefore, this statement does not indicate effective teaching.
Correct Answer is D
Explanation
Choice D rationale
Hyperosmolar Hyperglycemic Syndrome (HHS) is a serious complication of diabetes that occurs when blood sugar levels are extremely high. The primary treatment for HHS is intravenous fluids and insulin. Specifically, 0.9% saline solution IV is often used initially to restore volume and correct severe dehydration.
Choice A rationale
Administration of Glucagon is not the primary treatment for HHS. Glucagon is a hormone that raises blood glucose levels and would not be beneficial in a situation where blood glucose is already extremely high.
Choice B rationale
Dextrose 50% is a concentrated glucose solution and would not be appropriate in the treatment of HHS, where blood glucose levels are already dangerously high.
Choice C rationale
While IV fluids are a crucial part of the treatment for HHS, 0.45% Normal Saline (also known as half-normal saline) is a hypotonic solution and is not typically the first choice for fluid resuscitation in HHS. The preferred initial fluid is often 0.9% saline (normal saline), which is isotonic.
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