A client has been hospitalized for multiple sclerosis exacerbation and is being given high dose IV glucocorticoid steroid medications. The prescriber places new orders for weight based sliding scale insulin. The patient asks why they need insulin. Are they now diabetic? What is the nurse's best response?
Insulin is commonly given to all hospitalized clients.
You likely developed diabetes prior to hospitalization, but are just now being diagnosed.
You have developed type 1 diabetes and will need insulin for the rest of your life.
Glucocorticoid steroid medications can cause temporary hyperglycemia.
The Correct Answer is D
Choice A reason: This choice is incorrect because insulin is not commonly given to all hospitalized clients. Insulin is a hormone that lowers blood sugar levels in the body. It is only given to clients who have diabetes or other conditions that cause high blood sugar, such as pancreatitis, sepsis, or steroid therapy. The nurse should explain the indication and purpose of insulin to the client and not make false or misleading statements.
Choice B reason: This choice is incorrect because the client did not likely develop diabetes prior to hospitalization, but are just now being diagnosed. Diabetes is a chronic condition where the body either does not produce enough insulin or does not use it properly, resulting in high blood sugar levels. Diabetes can be diagnosed by measuring the blood sugar levels, the hemoglobin A1c levels, or the oral glucose tolerance test. The nurse should not assume or imply that the client has diabetes without proper testing and confirmation.
Choice C reason: This choice is incorrect because the client did not develop type 1 diabetes and will not need insulin for the rest of their life. Type 1 diabetes is an autoimmune condition where the body destroys the insulin-producing cells in the pancreas, leading to a complete lack of insulin. Type 1 diabetes usually develops in childhood or adolescence, and requires lifelong insulin therapy. The nurse should not diagnose or predict the client's condition without evidence or authority.
Choice D reason: This choice is correct because glucocorticoid steroid medications can cause temporary hyperglycemia. Glucocorticoids are anti-inflammatory drugs that suppress the immune system and reduce inflammation. They are used to treat conditions such as multiple sclerosis, asthma, rheumatoid arthritis, and allergic reactions. However, they can also increase the blood sugar levels by stimulating the liver to produce more glucose and reducing the sensitivity of the cells to insulin. The nurse should inform the client that the insulin is needed to control the blood sugar levels while they are on steroid therapy, and that the insulin dose may be adjusted or discontinued when the steroids are tapered or stopped.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","B","D","E"]
Explanation
Choice A reason: Using a soft bristled tooth brush can prevent gum bleeding and irritation that may occur with a hard bristled tooth brush. Gum bleeding can be a sign of excessive anticoagulation and increased risk of bleeding.
Choice B reason: Reporting black or bloody bowel movements is important because it can indicate gastrointestinal bleeding, which can be a serious complication of warfarin therapy. Gastrointestinal bleeding can cause anemia, shock, and even death if not treated promptly.
Choice C reason: Limiting all fruits and vegetables is not necessary for a client taking warfarin. However, some fruits and vegetables, especially those that are high in vitamin K, can interfere with the effect of warfarin and increase the risk of clotting. Vitamin K is found in green leafy vegetables, such as spinach, kale, broccoli, and cabbage, and some fruits, such as avocado, kiwi, and grapes. The client should maintain a consistent intake of vitamin K and avoid sudden changes in their diet.
Choice D reason: Reporting coffee ground or bloody emesis is also important because it can indicate upper gastrointestinal bleeding, which can be another serious complication of warfarin therapy. Upper gastrointestinal bleeding can cause hematemesis, melena, anemia, and hypovolemic shock.
Choice E reason: Shaving with an electric razor instead of a razor blade can prevent skin cuts and bleeding that may occur with a razor blade. Skin cuts and bleeding can be a sign of excessive anticoagulation and increased risk of bleeding.
Correct Answer is ["25"]
Explanation
To calculate the IV flow rate in drops per minute (gtt/min) for the administration of clindamycin, we can follow these steps:
First, we need to determine the total number of minutes for the infusion, which is given as 1 hour:
1 hour × 60 minutes/hour = 60 minutes
Next, we calculate the total number of drops needed for the infusion:
The total volume to be infused is 100 mL.
The drop factor is 15 gtt/mL.
100 mL × 15 gtt/mL = 1500 gtt
Calculate the IV flow rate in drops per minute:
1500 gtt ÷ 60 min = 25 gtt/min
Rounding to the nearest whole number, the nurse should set the IV flow rate to deliver 25 gtt/min.
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