14:20: 87-year-old client admitted to the ED from the independent living apartment with a new report of episodic acute confusion. urinary frequency and incontinence, and severe fatigue. The child states that the client is independent in ADCs and has no history of dementia.

15:30: Normal BMP and CBC results, except for WBCs of 16,000/mm3 (16 x 109 /L) with bands greater than 10%.

Based on the assessment findings presented which condition would the nurse suspect?

Glycosylated hemoglobin (HbA1c) is a measure of the average blood glucose levels over the past 2-3 months. An HbA1c level of less than 7% is associated with a reduced risk of microvascular and macrovascular complications in patients with diabetes. This is a critical goal because uncontrolled blood glucose levels can lead to complications such as neuropathy, nephropathy, retinopathy, and cardiovascular disease.

While options a, c, and d are also important in the management of diabetes, they are not as critical as achieving glycemic control. Choosing a diet that distributes calories throughout the day can help regulate blood glucose levels and prevent hypoglycemia. Following a diet and exercise plan that results in weight loss can also help improve glycemic control and reduce the risk of complications. Understanding the reasons for eliminating simple sugars in the diet is important for overall diabetes education, but it is not the most important goal in the plan of care for this patient at this time.

Diabetes insipidus is a condition in which the body is unable to properly regulate fluid balance, leading to excessive urination (polyuria) and thirst. Therefore, the nurse should anticipate the clinical manifestation of polyuria in a patient admitted to the hospital with diabetes insipidus. The patient may excrete large amounts of dilute urine, which can lead to dehydration if adequate fluid replacement is not provided. The other options listed (fluid volume overload, decreased gas exchange, and generalized edema) are not typically associated with diabetes insipidus, as this condition is characterized by a deficiency of antidiuretic hormone (ADH) rather than an excess of fluid.