A 53-year-old male patient with deep partial-thickness burns from a chemical spill in the workplace has severe pain followed by nausea during dressing changes.

Which action will be most useful in decreasing the patient's nausea?

In acute adrenal insufficiency, also known as Addison's disease, the adrenal glands are unable to produce enough cortisol and aldosterone hormones. These hormones play an important role in regulating sodium and potassium levels in the body. Therefore, a patient with acute adrenal insufficiency may have low sodium and high potassium levels in their blood.

The goal of therapy is to replace the deficient hormones and normalize the electrolyte levels in the body. If the current therapies are effective, the nurse would expect to see an increase in the patient's serum sodium levels because of aldosterone replacement therapy. Therefore, option a is the correct answer.

Decreasing serum chloride levels and decreasing blood glucose levels are not directly related to the treatment of acute adrenal insufficiency. In fact, a patient with acute adrenal insufficiency may have low serum chloride levels and low blood glucose levels due to the lack of cortisol hormone.

Increasing serum potassium levels would be an indicator of ineffective treatment or inadequate aldosterone replacement therapy, as aldosterone helps to regulate potassium levels in the body.

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.