The nurse is providing discharge instructions to an older adult client who has diabetes mellitus and is taking oral hypoglycemic agents.
The nurse should advise the client to do which of the following?
Check blood glucose levels at least four times a day.
Drink plenty of fluids and avoid caffeine
Eat small, frequent meals and avoid simple sugars.
Report any signs of infection or delayed wound healing.
The Correct Answer is D
The correct answer is D.
Report any signs of infection or delayed wound healing.
This is because oral hypoglycemic agents lower the blood glucose level, but they do not prevent the complications of diabetes mellitus, such as impaired wound healing and increased susceptibility to infections. Therefore, the client should be advised to monitor for any signs of infection, such as fever, redness, swelling, or pus, and report them to the health care provider promptly.
Choice A is wrong because checking blood glucose levels at least four times a day is not necessary for most clients who are taking oral hypoglycemic agents.
The frequency of blood glucose monitoring depends on the type and dose of medication, the level of glycemic control, and the presence of other factors that may affect blood glucose, such as illness or stress. The client should follow the individualized plan prescribed by the health care provider regarding blood glucose monitoring.
Choice B is wrong because drinking plenty of fluids and avoiding caffeine is not specific to clients who are taking oral hypoglycemic agents.
This is a general recommendation for all clients who have diabetes mellitus, as dehydration and caffeine can worsen hyperglycemia and increase the risk of diabetic ketoacidosis or hyperosmolar hyperglycemic state. However, this alone is not sufficient to manage diabetes mellitus and prevent complications.
Choice C is wrong because eating small, frequent meals and avoiding simple sugars is also a general recommendation for all clients who have diabetes mellitus, as this can help to maintain a stable blood glucose level and prevent hypoglycemia or hyperglycemia.
However, this alone is not sufficient to manage diabetes mellitus and prevent complications. The client should also follow a balanced diet that includes complex carbohydrates, protein, fiber, and healthy fats, and consult with a dietitian or a diabetes educator for individualized dietary guidance.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","B","C","D"]
Explanation
The correct answer isA, B, C and D.
These are all factors that can increase the risk of sexually transmitted infections (STIs) in older adult clients.
A. Decreased immune system function with aging.This can make older adults more susceptible to infections and less able to fight them off.
B. Lack of knowledge or awareness about STIs.
Older adults may not have received adequate education or information about STIs, their symptoms, prevention and treatment.They may also have misconceptions or stigma about STIs that prevent them from seeking help or testing.
C. Reduced use of condoms or other barrier methods.
Older adults may not perceive themselves as at risk of STIs or may not know how to use condoms correctly or consistently.They may also face barriers such as cost, availability, embarrassment or partner resistance to using condoms.
D. Increased number of sexual partners or casual encounters.
Older adults may have more opportunities for sexual activity due to factors such as divorce, widowhood, online dating, travel or retirement.They may also engage in sexual behaviors that expose them to multiple or unknown partners, such as sex work, drug use or group sex.
Choice E is wrong becauseincreased vaginal dryness or atrophy with menopauseis not a risk factor for STIs in older adult clients.
While this condition can cause discomfort, pain or bleeding during sexual intercourse, it does not increase the likelihood of acquiring or transmitting an STI.However, it may affect the quality of life and sexual satisfaction of older women and their partners, and may require medical attention or lubrication products.
: Johnson BK.
Sexually transmitted infections and older adults.J Gerontol Nurs 2013;39(11):53-60.: World Health Organization (WHO).
Sexually transmitted infections (STIs).2022 Aug 22.: Journal of Gerontological Nursing (JGN).
Sexually Transmitted Infections and Older Adults.
2013 Sep 18.
Correct Answer is A
Explanation
The correct answer is A.
Adverse drug reactions.
Polypharmacy, which refers to the effects of taking multiple medications concurrently to manage coexisting health problems, is common among older adults.
It is defined as the regular use of at least five medications.
Polypharmacy can lead to an increase in geriatric syndromes, decrease in functional outcomes, and increased mortality.
One of the major risks of polypharmacy is adverse drug reactions, which are harmful or unintended effects of a medication that occur at normal doses.
Adverse drug reactions can result from drug-drug interactions, drug-disease interactions, drug-age interactions, or inappropriate prescribing.
Adverse drug reactions can cause symptoms such as confusion, dizziness, falls, bleeding, or organ damage.
They can also lead to hospitalizations, increased health care costs, and reduced quality of life.
Choice B is wrong because medication adherence, which is the extent to which patients take medications as prescribed by their health care providers, can actually decrease with polypharmacy.
This is because taking multiple medications can be complex, costly, and burdensome for older adults, especially if they have cognitive impairment or low health literacy.
Medication adherence can also be influenced by patients’ beliefs, preferences, and expectations about their medications.
Choice C is wrong because drug-drug interactions are not a risk of polypharmacy per se, but rather a cause of adverse drug reactions.
Drug-drug interactions occur when two or more drugs affect each other’s pharmacokinetics (absorption, distribution, metabolism, excretion) or pharmacodynamics (mechanism of action, efficacy, toxicity).
Drug-drug interactions can alter the therapeutic effects or safety of a medication.
Choice D is wrong because therapeutic effects are the intended or desired effects of a medication that benefit the patient’s health condition.
Therapeutic effects can decrease with polypharmacy due to drug-drug interactions that reduce the efficacy of a medication.
Therapeutic effects can also be diminished by prescribing cascade, which is a phenomenon where a new medication is prescribed to treat a symptom that is actually an adverse drug reaction of another medication.
Normal ranges for blood pressure are.
≤120/80.
mmHg for normal,.
120−129/80.
mmHg for elevated,.
130−139/80−89.
mmHg for stage 1 hypertension, and.
≥140/90.
mmHg for stage 2 hypertension.
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