The nurse is planning discharge teaching for a client with type 2 diabetes mellitus (DM) who has a now prescription for insulin glargine. Which action should the nurse plan to include in the discharge teaching?
Provide information on increasing medication dosage If ketoacidosis occurs.
Teach the client self-injection skills for daily subcutaneous administration.
Demonstrate how to select dose based on before meal blood sugar readings.
Explain to the family how to inject this medication for severe hypoglycemia.
The Correct Answer is B
A) Provide information on increasing medication dosage if ketoacidosis occurs: While it is important for clients with diabetes to understand the signs and symptoms of diabetic ketoacidosis (DKA) and how to respond, increasing insulin dosage on their own without healthcare provider guidance could be dangerous. Adjusting insulin dosage should always be done under the direction of a healthcare provider.
B) Teach the client self-injection skills for daily subcutaneous administration: Insulin glargine is a long-acting insulin used for basal (background) insulin coverage in clients with diabetes. Teaching the client how to self-administer insulin injections is essential for effective management of diabetes, especially when using long-acting insulin formulations like insulin glargine. Proper injection technique, site rotation, and storage of insulin are important aspects of this teaching.
C) Demonstrate how to select dose based on before meal blood sugar readings: Insulin glargine is typically administered once daily at the same time each day and is not adjusted based on before meal blood sugar readings. Instead, it provides a steady level of insulin over 24 hours to help control blood sugar levels between meals and overnight.
D) Explain to the family how to inject this medication for severe hypoglycemia: Insulin glargine is not used for the treatment of severe hypoglycemia. Instead, it is a long-acting insulin used to maintain basal insulin levels in clients with diabetes. Severe hypoglycemia is treated with fast-acting glucose sources such as oral glucose tablets, gel, or glucagon injections, and the family should be educated on these treatments instead.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A) Acetaminophen is metabolized by the liver, and jaundice can indicate liver dysfunction or impairment. Therefore, the nurse should notify the healthcare provider about the scheduled acetaminophen to ensure appropriate monitoring of liver function and to consider alternative pain management options.
B) Prednisone is a corticosteroid that primarily affects the immune system and inflammation and is not directly metabolized by the liver. While prednisone can have side effects related to liver function, such as hepatotoxicity, jaundice is not a common manifestation.
C) Captopril is an angiotensin-converting enzyme (ACE) inhibitor used to treat hypertension and heart failure. While it can affect renal function, jaundice is not a typical side effect of captopril.
D) Omeprazole is a proton pump inhibitor (PPI) used to reduce gastric acid production and treat conditions such as gastroesophageal reflux disease (GERD). It is primarily metabolized in the liver, but jaundice is not a common side effect associated with its use.
Correct Answer is B
Explanation
A) A serum creatinine level of 1.0 mg/dL falls within the reference range (0.5 to 1.1 mg/dL) and does not indicate immediate action by the nurse. Creatinine levels within the reference range suggest normal kidney function.
B) A platelet count of 100,000/mm3 (100 x 10^9/L) is below the lower limit of the reference range (150,000 to 400,000/mm3). Thrombocytopenia, or low platelet count, increases the risk of bleeding complications, especially when administering anticoagulants like enoxaparin. Therefore, a platelet count of 100,000/mm3 requires immediate action by the nurse to assess for bleeding and notify the healthcare provider.
C) A hematocrit of 45% (0.45 volume fraction) falls within the reference range (42% to 52%) and does not indicate immediate action by the nurse.
D) A blood urea nitrogen (BUN) level of 20 mg/dL (7.1 mmol/L) falls within the reference range (10 to 20 mg/dl) and does not indicate immediate action by the nurse.
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