The nurse teaches a diabetic client about Sick Day Rules. Which patient statement or statements indicate understanding of the Sick Day Rules? (SELECT ALL THAT APPLY)

I will report nausea, vomiting, or diarrhea to my primary care provider.

I should avoid carbohydrates when I'm sick.

I should stop taking my insulin or oral antidiabetic agents.

I will test my blood glucose and test urine ketones every 3 to 4 hours.

I will continue taking my insulin or oral antidiabetic agents as usual.

Answer and Explanation

Correct Answer : A,D,E

A. I will report nausea, vomiting, or diarrhea to my primary care provider.
Correct Understanding: This is correct. Reporting these symptoms is essential because illness, especially with symptoms like nausea, vomiting, or diarrhea, can impact blood glucose levels.

B. I should avoid carbohydrates when I'm sick.
Need for Further Teaching: During illness, it's important to continue consuming carbohydrates. However, the type and amount of carbohydrates might need to be adjusted. Patients should consult their healthcare providers for guidance on managing carbohydrate intake during illness.

C. I should stop taking my insulin or oral antidiabetic agents.
Need for Further Teaching: It is not advisable to stop insulin or oral antidiabetic agents during illness. In fact, these medications often need to be continued, with potential adjustments made under the guidance of healthcare providers.

D. I will test my blood glucose and test urine ketones every 3 to 4 hours.
Correct Understanding: This is correct. Regular monitoring of blood glucose and urine ketones during illness is crucial for managing diabetes and detecting any potential complications.

E. I will continue taking my insulin or oral antidiabetic agents as usual.
Correct Understanding: This is correct. It's important to continue taking insulin or oral antidiabetic agents during illness to help manage blood glucose levels.

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Free Nursing Study Resources

Correct Answer is D

Explanation

A. Aspirin Toxicity:
Effect on Blood Gases: Aspirin toxicity can cause respiratory alkalosis due to increased respiratory rate (hyperventilation), leading to a decreased PaCO2 and increased pH.
Relation to Given Blood Gases: It could potentially cause the observed blood gas values (low PaCO2 and high pH), making it a possible cause.

B. Fever:
Effect on Blood Gases: Fever might cause hyperventilation, resulting in respiratory alkalosis with decreased PaCO2 and increased pH.
Relation to Given Blood Gases: It could potentially cause the observed blood gas values.

C. Anxiety Attack:
Effect on Blood Gases: Anxiety attacks can lead to hyperventilation and subsequent respiratory alkalosis with low PaCO2 and high pH.
Relation to Given Blood Gases: It could potentially cause the observed blood gas values.

D. Chronic Obstructive Pulmonary Disease (COPD):
Effect on Blood Gases: COPD typically causes respiratory acidosis due to impaired gas exchange, resulting in elevated PaCO2 and decreased pH.
Relation to Given Blood Gases: COPD wouldn't typically cause the observed blood gas values of low PaCO2 and high pH.

A. "Diet, exercise and oral medications can be effective. I will ask the physician to prescribe Metformin" B. "Your body does not produce insulin, and the only treatment is injected insulin" C. "Glucophage can help your body better utilize the insulin secreted by the pancreas" D. "Initially, you will need injections, but after your body adjusts to the insulin, you can switch to Metformin"

Correct Answer is B

Explanation

A. "Diet, exercise, and oral medications can be effective. I will ask the physician to prescribe Metformin":
Explanation: This statement is not accurate for type 1 diabetes. Type 1 diabetes results from the inability of the pancreas to produce insulin, so oral medications like Metformin, which work to increase insulin sensitivity or reduce glucose production in the liver, are not effective. Insulin replacement is the mainstay of treatment for type 1 diabetes.

B. "Your body does not produce insulin, and the only treatment is injected insulin":
Explanation: This is the correct statement. In type 1 diabetes, the pancreas does not produce insulin or produces very little, and insulin cannot be taken orally because it would be broken down in the digestive system. Therefore, injections are the primary and necessary mode of insulin delivery.

C. "Glucophage can help your body better utilize the insulin secreted by the pancreas":
Explanation: This statement is more applicable to type 2 diabetes, where the pancreas may still produce insulin, but the body's cells are resistant to its effects. In type 1 diabetes, the issue is a lack of insulin production, so medications to improve insulin utilization are not relevant.

D. "Initially, you will need injections, but after your body adjusts to the insulin, you can switch to Metformin":
Explanation: This is not accurate for type 1 diabetes. The need for insulin in type 1 diabetes is not something the body adjusts to over time. Insulin is a lifelong requirement for individuals with type 1 diabetes, and it cannot be replaced by oral medications like Metformin.

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The nurse teaches a diabetic client about Sick Day Rules. Which patient statement or statements indicate understanding of the Sick Day Rules? (SELECT ALL THAT APPLY)

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A patient has the following blood gases: PaCO2 33, pH 7.50, HCO3 23. Which of the following could NOT be the cause of this condition?

Correct Answer is D

Explanation

A client diagnosed with type 1 diabetes states he is not comfortable with self-injections and asks the nurse if oral an anti- diabetic agent can be prescribed instead. Which of the following responses from the nurse is appropriate?

Correct Answer is B

Explanation

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The nurse instructs the client about the self-administration of insulin. Which statement or statements by the patient indicate a need for further teaching? (SELECT ALL THAT APPLY)

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