The nurse is assessing an adult patient with Type 1 diabetes mellitus. Which labs result should be reported to the physician immediately? Select the "3" findings that require immediate follow-up.

Blood glucose 112 mg/dL

Hemoglobin A1C 6.0%

Hemoglobin 10.2 g/dl

Creatinine 2.5 mg/dl

Microalbuminuria 40mg/24hours

Positive ketones in the urine

Answer and Explanation

The Correct Answer is ["C","D","F"]

A. Blood glucose 112 mg/dL: This glucose level is within the target fasting range for patients with Type 1 diabetes. It indicates good short-term glucose control and does not pose an immediate clinical concern, so it does not require urgent physician notification.

B. Hemoglobin A1C 6.0%: An A1C of 6.0% reflects strong long-term glycemic control. This value is below the ADA-recommended goal of <7% for most adults with diabetes, indicating stability and no need for immediate intervention.

C. Hemoglobin 10.2 g/dL: This indicates mild to moderate anemia, which could be due to chronic kidney disease a common diabetic complication. It may reflect decreased erythropoietin production from renal impairment and should be evaluated promptly to prevent worsening.

D. Creatinine 2.5 mg/dL: This level is significantly elevated, suggesting renal dysfunction, which is serious in a patient with diabetes. It may signal progression of diabetic nephropathy or acute kidney injury and warrants immediate medical evaluation and intervention.

E. Microalbuminuria 40 mg/24 hours: This indicates early kidney damage but is not an emergent finding. While it supports the diagnosis of diabetic nephropathy, it does not require urgent reporting unless accompanied by worsening renal function or other critical signs.

F. Positive ketones in the urine: Ketones in the urine suggest fat breakdown due to insufficient insulin and risk of diabetic ketoacidosis (DKA). This is an acute and potentially life-threatening complication of Type 1 diabetes that requires immediate physician notification and intervention.

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Correct Answer is {"A":{"answers":"A"},"B":{"answers":"A"},"C":{"answers":"A"},"D":{"answers":"C"},"E":{"answers":"B"}}

Explanation

Assessment Finding	Improved	No Change	Declined
Blood pressure	✓
Respirations	✓
Hyperglycemia	✓
Temperature			✓
Heart Rate		✓

Rationale:

Blood pressure: Blood pressure increased from 90/58 mmHg at 2000 to 112/60 mmHg at 2100, reflecting hemodynamic stabilization likely due to fluid resuscitation and correction of hypoglycemia. This improvement indicates better cardiovascular status.
Respirations: Respiratory rate decreased from 26 breaths/min at 2000 to 20 breaths/min at 2100, with respiration described as even and unlabored. This suggests resolution of metabolic acidosis and respiratory compensation.
Hyperglycemia: Capillary blood glucose decreased from 420 mg/dL on admission to 120 mg/dL at 2100. This indicates effective glycemic control after insulin therapy and glucose administration.
Temperature: Temperature increased from 98.0°F at 2000 to 100.2°F at 2100, indicating development of fever. This suggests possible infection or inflammatory process is ongoing or worsening.
Heart Rate: No Heart rate remained elevated (118 bpm at 2000 and 120 bpm at 2100) with minimal variation, suggesting persistent sympathetic stimulation or stress response without significant improvement.

A. Include foods high in starch and proteins. B. Include foods high in fiber. C. Avoid foods high in sodium. D. Avoid foods high in fat.

Correct Answer is D

Explanation

A. Include foods high in starch and proteins: Excessive amounts particularly of protein can stimulate gallbladder contractions, potentially triggering pain. This recommendation however does not directly address the dietary trigger for biliary colic, which is typically high-fat foods.

B. Include foods high in fiber: A high-fiber diet can support overall digestive health and may help reduce cholesterol. However, fiber intake is not the primary dietary concern in managing biliary colic episodes. The focus should be more on reducing fat intake to prevent gallbladder stimulation.

C. Avoid foods high in sodium: High sodium intake is not directly associated with the triggering of biliary colic. Avoiding fat is far more critical in this condition, as dietary fat stimulates bile release and gallbladder contraction, which can provoke pain.

D. Avoid foods high in fat: Fatty foods stimulate the gallbladder to contract and release bile, which can lead to painful episodes of biliary colic in individuals with cholecystitis. A low-fat diet reduces gallbladder workload and helps prevent symptom flare-ups, making this the most important dietary instruction for these patients.

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The nurse is assessing an adult patient with Type 1 diabetes mellitus. Which labs result should be reported to the physician immediately? Select the "3" findings that require immediate follow-up.

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is caring for a patient with diabetes. Exhibits For each assessment finding, click to specify if the finding indicates that the client's condition has improved, has not changed, or has declined. Only choose one option for each assessment finding. Each option will be used at least once.

Correct Answer is {"A":{"answers":"A"},"B":{"answers":"A"},"C":{"answers":"A"},"D":{"answers":"C"},"E":{"answers":"B"}}

Explanation

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Correct Answer is D

Explanation

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