A Type 1 diabetic client with a morning (fasting) glucose of 260 mg/dL has been diagnosed with the Somogyi effect from insulin administration.
What intervention should the nurse anticipate including in the plan of care?
Increase the nighttime insulin glargine dose.
Ensure a snack is consumed at bedtime.
Check the morning cortisol level.
Check the glucose level at 2 a.m. and 8 a.m.
The Correct Answer is B
Choice A rationale
Increasing the nighttime insulin glargine dose may exacerbate the Somogyi effect, a phenomenon where the blood sugar level drops too low overnight, causing a rebound high blood sugar level in the morning.
Choice B rationale
Consuming a snack at bedtime can help prevent the blood sugar level from dropping too low overnight, thus preventing the Somogyi effect.
Choice C rationale
Checking the morning cortisol level is not directly related to managing the Somogyi effect.
Choice D rationale
Checking the glucose level at 2 a.m. and 8 a.m. can help identify the Somogyi effect, but it does not prevent it.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale
Soaking feet once daily in warm water is not recommended for diabetic patients. This is because prolonged soaking can lead to skin breakdown and increase the risk of foot ulcers and infections.
Choice B rationale
Utilizing a mirror to examine the soles of the feet is a recommended practice for diabetic patients. This allows them to check for any cuts, sores, blisters, or changes in the skin that they may not be able to see otherwise. Early detection of these issues can prevent serious complications such as infections and ulcers.
Choice C rationale
Cutting nails in a curved direction is not advised for diabetic patients. This can lead to ingrown toenails, which can cause sores and infections. It’s recommended to cut the nails straight across to avoid this.
Choice D rationale
Using a commercial medicine to remove a corn is not recommended for diabetic patients. These products can damage the skin and increase the risk of ulcers and infections. Any issues with corns or calluses should be addressed by a healthcare professional.
Correct Answer is D
Explanation
Choice A rationale
While it’s important for clients to understand their medications, not having received proper education on this medication is not a reason to withhold cefazolin.
Choice B rationale
Completing a full course of an aminoglycoside antibiotic does not contraindicate the use of cefazolin.
Choice C rationale
Being afebrile does not contraindicate the use of cefazolin. Antibiotics are used to treat bacterial infections, not just to reduce fever.
Choice D rationale
A prior anaphylactic reaction to penicillin is a contraindication for administering cefazolin. Cefazolin is a cephalosporin, and there is a risk of cross-reactivity and potential allergic reaction in clients who have a history of severe penicillin allergy.
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