The healthcare provider prescribes a 5% dextrose injection with 20 units of regular insulin for a client with a serum potassium level of 6.0 mEq/L (6.0 mmol/L) and glucose level of 180 mg/dL (10.0 mmol/L). Which evaluation is most important for the nurse to include in this client's plan of care?

Reference Range:

Potassium [3.5 to 5.0 mEq/L (3.5 to 5.0 mmol/L)]

Glucose [74 to 106 mg/dL (4.1 to 5.9 mmol/L)]

Choice A reason: A headache with blurred vision following alteplase administration could indicate intracranial hemorrhage, which requires immediate intervention.

Choice B reason: Lower extremity edema is not typically an immediate concern post-alteplase administration unless it indicates a deep vein thrombosis.

Choice C reason: Paroxysmal supraventricular tachycardia requires monitoring, but it is not as urgent as a headache with blurred vision, which could signify a life-threatening complication.

Choice D reason: Frequent premature ventricular contractions should be monitored, but they are not as critical as a headache with blurred vision post-alteplase.

Choice A Reason: Weight reduction treatment is a modifiable risk factor for prediabetes. Losing a small amount of weight, around 5% to 7% of body weight, can significantly lower the risk of developing type 2 diabetes. For a 200-pound person, this means losing about 10 to 14 pounds.
Choice B Reason: Exercise planning is crucial as it helps improve insulin sensitivity and glucose metabolism. The recommendation is at least 150 minutes per week of moderate-intensity physical activity, such as brisk walking or light cycling.
Choice C Reason: Long-acting insulin is not typically used in the management of prediabetes. Insulin therapy is more commonly a part of the treatment regimen for individuals with type 1 diabetes or those with type 2 diabetes who cannot control their blood glucose levels with oral medications.
Choice D Reason: Nutrition education is essential for managing prediabetes. A diet rich in fiber, whole grains, and non-starchy vegetables, and low in added sugars and saturated fats, can help manage blood glucose levels3.
Choice E Reason: Extra carbohydrates are not recommended for prediabetes management as they can lead to increased blood glucose levels. Instead, a balanced diet with controlled carbohydrate intake is advised.
Choice F Reason: Oral antidiabetic medications, such as metformin, may be prescribed to help lower blood glucose levels and improve insulin sensitivity in individuals with prediabetes.
Choice G Reason: Short-acting insulin is not indicated for prediabetes management for the same reasons as long-acting insulin; it is not typically part of the treatment regimen unless the individual has progressed to type 2 diabetes and requires insulin therapy.