A client who has type 1 diabetes mellitus asks a nurse about beginning an exercise regimen.

Which of the following instructions should the nurse include?

Crackles heard in the lungs.

Fluid overload occurs when there is an excessive accumulation of fluid in the body, and it can occur in clients receiving enteral tube feedings. Crackles heard in the lungs, also known as rales, are abnormal lung sounds that can indicate the presence of fluid in the lungs. These crackling sounds occur when there is an excess of fluid in the alveoli or when air passes through fluid- filled airways. Crackles can be heard during auscultation of the lungs using a stethoscope and are a significant sign of fluid overload.

decreased skin turgor in (option A) is incorrect because it, is a sign of dehydration rather than fluid overload. Decreased skin turgor occurs when the skin lacks elasticity and is often seen in clients who are dehydrated.

weight loss in (option C) is incorrect because it, is not typically associated with fluid overload. Fluid overload usually results in weight gain or fluid retention rather than weight loss.

decreased blood pressure in (option D) is incorrect because it, is more commonly associated with hypovolemia or fluid deficit rather than fluid overload. In fluid overload, blood pressure may be elevated due to increased fluid volume.

In summary, crackles heard in the lungs are a manifestation of fluid overload and can be a significant sign for the nurse to assess and address in a client receiving enteral tube feedings.

Insulin lispro is a rapid-acting insulin, while insulin glargine is a long-acting insulin. It is important to keep them separate to maintain their individual properties and avoid any potential interactions or changes in their effectiveness.

Insulin glargine is a clear solution and should not appear cloudy. Cloudiness in insulin can indicate contamination or improper storage.

The instruction to "take an extra dose of insulin lispro prior to aerobic exercise" is not recommended. The client should consult with their healthcare provider to determine if any adjustments to their insulin regimen are necessary for exercise. Typically, adjustments are made based on the individual's blood glucose levels and anticipated intensity and duration of exercise. Insulin glargine is a long-acting insulin that provides a steady release of insulin over a prolonged period, without distinct peaks or valleys in its action. Its onset of action is gradual and its effect lasts for approximately 24 hours.

It is important for the client to receive accurate and appropriate instructions regarding their insulin regimen. The nurse should clarify any misunderstandings and provide accurate information to promote safe and effective diabetes management.