Which situation would most appropriately describe a client possibly require glucose management by sliding scale insulin?

A. The nurse will monitor the client's blood glucose levels four (4) times a day: This is important, but it is an intervention rather than a goal. A goal should be measurable and focused on the client's outcome, such as maintaining specific glucose levels.

B. The client will demonstrate appropriate insulin injection techniques: This is a good educational goal, but it does not directly address the immediate concern. The problem states noncompliance, implying the client knows how to inject but isn't doing it consistently.

C. The client will maintain normal kidney function with 30-ml/hr urine output: While monitoring kidney function is important in diabetes, this goal does not address the immediate risk of hyperglycemia. Urine output is not the primary indicator of hyperglycemia.

D. The client will have a blood glucose level between 60-110 mg/dl at 1600: This short-term goal is specific, measurable, and time-bound. It addresses the desired outcome of maintaining blood glucose within a normal range, which addresses hyperglycemia due to noncompliance.

A. “I will need to have my white blood cell count checked regularly while taking this medication.": Propylthiouracil (PTU)can cause agranulocytosis, a condition that reduces the number of white blood cells, increasing the risk of infection. Regular monitoring of the white blood cell countis important to detect this potential side effect early.

B. “This medication helps by blocking the production of thyroid hormones.": Propylthiouracil (PTU)works by inhibiting the production of thyroid hormonesin the thyroid gland, which helps in the treatment of hyperthyroidism.

C. “I need to check my blood glucose levels daily.”: PTUdoes not directly affect blood glucose levels. Monitoring blood glucose is recommended for patients on medications that affect insulin or blood sugar regulation, such as corticosteroids or some antipsychotic medications, not PTU.

D. “Once my symptoms improve, I can stop taking the medication without telling my provider.”: Clients should continue taking PTUas prescribed, even if symptoms improve. Discontinuing the medication without consulting the provider could lead to relapseor worsening of hyperthyroidism.

E. “If I feel extremely tired or notice yellowing of my skin, I should report it immediately.": Fatigueand yellowing of the skin (jaundice)can be signs of liver toxicity, a serious side effect of PTU. Any such symptoms should be reported immediately to prevent further complications.