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 A
Explanation
Choice A rationale
Diabetes mellitus can lead to several chronic complications, including retinopathy, which can cause blindness. Regular eye exams are crucial for early detection and treatment of diabetic retinopathy. Therefore, scheduling and keeping appointments for annual eye exams is an important part of managing diabetes.
Choice B rationale
While adequate fluid intake is generally important for overall health, it is not specifically effective in preventing kidney damage in patients with diabetes mellitus. Kidney damage in diabetes, also known as diabetic nephropathy, is caused by high blood sugar levels over time, not by dehydration.
Choice C rationale
Regular checks of cardiac enzymes are not a standard part of diabetes management. Cardiac enzymes are typically checked in the context of suspected heart disease or a heart attack, not as a routine measure in diabetes care.
Choice D rationale
While regular foot care is important in diabetes to prevent complications such as foot ulcers and infections, podiatry exams every 3 months are not typically necessary unless the patient has a history of foot problems or a high risk of foot complications.
Correct Answer is D
Explanation
Choice A rationale
While discussing the need for weight loss can be an important part of managing Type 2 diabetes, it should not necessarily be the initial step when developing an educational plan. Weight loss can help improve blood glucose control, but it’s just one aspect of a comprehensive diabetes management plan15.
Choice B rationale
Inviting the client’s family to participate in the program can be beneficial, as it can provide additional support for the client. However, the initial step in developing an educational plan should focus on the client’s understanding and perception of their diagnosis15.
Choice C rationale
Demonstrating how to check glucose using capillary blood glucose monitoring is an important skill for managing Type 2 diabetes. However, before teaching this skill, it’s important to assess the client’s understanding and readiness to learn15.
Choice D rationale
Assessing the client’s perception of what it means to live with diabetes should be the initial step when developing an educational plan. Understanding the client’s perspective can help tailor the education to meet their needs and improve their ability to manage their diabetes15.
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