The client diagnosed with Type I diabetes calls the clinic with a blood glucose level of 285 mg/dL and symptoms of a sore throat, cough, and fever. The clinic triage nurse advises the client to:

limit intake to non-caloric containing liquids until the glucose is within normal limits.

monitor blood glucose levels every 4 hours and go to the clinic if it continues to rise.

decrease intake of carbohydrates until blood glucose level is less than 200 mg/dL

hold the morning prescribed dose of insulin.

Answer and Explanation

The Correct Answer is B

A.   While staying hydrated is essential, especially during illness, limiting intake to non-caloric liquids could lead to inadequate caloric intake and worsen the client’s condition. Instead, the client should maintain a balanced intake of fluids and carbohydrates as tolerated.
B.   This is a reasonable approach. Monitoring blood glucose levels regularly allows the client to assess how their body is responding to the illness and any adjustments in insulin. If the levels continue to rise, it is important for the client to seek medical attention to prevent complications like diabetic ketoacidosis (DKA).
C.   While it is important to manage carbohydrate intake, completely decreasing carbohydrate intake can lead to inadequate caloric consumption, which is especially risky during an illness. The body needs energy, and people with diabetes must balance carbohydrate intake with insulin administration to avoid complications.
D.   Holding insulin can lead to dangerously high blood glucose levels. Clients with Type 1 diabetes require insulin regardless of illness, and it’s crucial to adjust the insulin regimen based on current blood glucose levels and carbohydrate intake.

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Correct Answer is C

Explanation

A. A serum fasting glucose level of 101 mg/dL indicates a mild elevation but is not significantly high enough to contraindicate the use of TMP-SMX. It does not directly relate to the medication’s safety.
B. A platelet count of 160,000 µL is within normal limits (normal range is typically 150,000-450,000 µL). This result does not indicate any contraindication for using TMP-SMX.

C. A serum creatinine level of 2.5 mg/dL indicates impaired kidney function (normal range is typically 0.6-1.2 mg/dL). TMP-SMX can be contraindicated in patients with significant renal impairment due to the potential for drug accumulation and toxicity, particularly affecting renal function.
D. A hemoglobin level of 13.6 g/dL is within normal limits (normal range is approximately 13.5-17.5 g/dL for males and 12.0-15.5 g/dL for females). This result does not indicate a contraindication for using TMP- SMX.

A. Dextrose 5% 0.45% Normal Saline IV B. Oxygen by nasal cannula C. 0.9% saline solution IV D. Administration of Glucagon

Correct Answer is C

Explanation

A. While D5 0.45% NS contains dextrose, it is not suitable as an initial treatment in HHS because patients are often hyperglycemic. Starting with dextrose can worsen hyperglycemia.
B. Although providing oxygen may be appropriate if the client shows signs of respiratory distress or hypoxia, it is not the first-line treatment for HHS. The immediate priority is addressing dehydration and hyperglycemia.
C. The initial therapy for HHS involves administering IV fluids, typically starting with 0.9% saline (normal saline). This helps to rapidly rehydrate the client and dilute the high glucose levels in the blood. Correcting dehydration is critical in HHS management.
D. Glucagon is typically used to treat hypoglycemia, not hyperglycemia. In HHS, the patient is hyperglycemic, so administering glucagon would not be appropriate.

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The client diagnosed with Type I diabetes calls the clinic with a blood glucose level of 285 mg/dL and symptoms of a sore throat, cough, and fever. The clinic triage nurse advises the client to:

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Naxlex Comprehensive Predictor Exams

A newly admitted client has been prescribed sulfamethoxazole/trimethoprim. The nurse understands that this medication is contraindicated based on which lab result?

Correct Answer is C

Explanation

A client with Type 2 diabetes is brought into the emergency room in an unresponsive state. A diagnosis of Hyperosmolar Hyperglycemic Syndrome (HHS) is made. The nurse prepares for the administration of which initial therapy?

Correct Answer is C

Explanation

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