A patient with type 1 diabetes has influenza. The nurse should instruct the patient to:
Increase the frequency of self-monitoring blood glucose levels
Discontinue the dose of insulin if unable to eat
Reduce food intake to diminish nausea
Take half of the normal dose of insulin
The Correct Answer is A
Choice A reason: Influenza increases metabolic stress, elevating blood glucose in type 1 diabetes due to stress hormones like cortisol and catecholamines, which promote gluconeogenesis. Frequent glucose monitoring ensures timely insulin adjustments, preventing hyperglycemia or diabetic ketoacidosis, critical for managing acute illness in insulin-dependent patients.
Choice B reason: Discontinuing insulin in type 1 diabetes, even during reduced food intake, is dangerous. Insulin is essential to prevent diabetic ketoacidosis, as the body continues gluconeogenesis and fat metabolism without it, leading to severe acidosis and metabolic collapse, making this instruction incorrect.
Choice C reason: Reducing food intake to diminish nausea may worsen glycemic control in type 1 diabetes. Illness increases glucose levels, requiring consistent carbohydrate intake to prevent hypoglycemia or ketosis. This approach ignores the need for balanced nutrition and insulin adjustments during illness, making it inappropriate.
Choice D reason: Taking half the insulin dose is unsafe, as illness often increases insulin requirements due to stress-induced hyperglycemia. Arbitrary dose reduction risks diabetic ketoacidosis, as insufficient insulin fails to counter gluconeogenesis and ketogenesis, making this instruction dangerous for type 1 diabetes management during influenza.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason: Hepatitis C is primarily transmitted through blood contact, such as needle sharing or transfusions, not contaminated food. It causes chronic liver infection and is not associated with foodborne transmission, making it an unlikely cause in this scenario of hepatitis from contaminated food.
Choice B reason: Hepatitis A is transmitted via the fecal-oral route, often through contaminated food or water. It causes acute hepatitis with symptoms like jaundice and nausea, resolving without chronicity. This matches the scenario of foodborne transmission, making it the most likely diagnosis.
Choice C reason: Hepatitis D occurs only as a co-infection with hepatitis B, transmitted through blood or sexual contact, not food. It requires hepatitis B for replication and is not associated with foodborne transmission, making it incorrect for this scenario.
Choice D reason: Hepatitis B is transmitted through blood, sexual contact, or perinatal exposure, not contaminated food. It can cause chronic liver disease but is not linked to foodborne transmission, making it an incorrect choice for hepatitis contracted from contaminated food.
Correct Answer is A
Explanation
Choice A reason: Polycystic is not a recognized symptom of HHS. The term may be confused with polycystic ovary syndrome, unrelated to HHS. HHS involves severe hyperglycemia causing dehydration, not ovarian pathology, making this sign irrelevant to the metabolic and osmotic disturbances characteristic of this condition.
Choice B reason: Polyphagia, increased hunger, is associated with HHS due to cellular glucose starvation from severe hyperglycemia. Without adequate insulin, glucose cannot enter cells, triggering hunger as the body seeks energy, making this a relevant symptom in the hyperosmolar state of HHS.
Choice C reason: Polydipsia, excessive thirst, is a hallmark of HHS. Severe hyperglycemia causes osmotic diuresis, leading to dehydration and increased plasma osmolality, stimulating the thirst center to compensate for fluid loss, making this a common and expected symptom in HHS patients.
Choice D reason: Polyuria, excessive urination, is a classic HHS symptom. High blood glucose exceeds renal reabsorption capacity, causing osmotic diuresis, which increases urine output and leads to dehydration. This is a key feature of HHS, driving fluid and electrolyte imbalances in affected patients.
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