A client with a history of type 1 diabetes mellitus (DM) and asthma is readmitted to the unit for the third time in two months with a current fasting blood sugar (FBS) is 325 mg/dL (18 mmol/L). The client describes to the nurse of not understanding why the blood glucose level continues to be out of control. Which intervention(s) should the nurse implement? (Select all that apply.)
Have the client demonstrate technique used to monitor blood glucose levels.
Evaluate the client's asthma medications that can elevate the blood glucose.
Ask the client if they want a different manufacturer's glucose monitoring device.
Understand the client's daily routine
Ensuring the client uses a new insulin needle for each administration
Correct Answer : A,B,D,E
A) Correct - Demonstrating the technique used to monitor blood glucose levels is crucial.
Incorrect technique can lead to inaccurate readings, impacting insulin dosing decisions and blood sugar control.
B) Correct - Some asthma medications, like corticosteroids, can elevate blood glucose levels.
Evaluating the client's asthma medications is essential as they can contribute to fluctuations in blood sugar levels.
C) Incorrect- Asking the client if they want a different manufacturer's glucose monitoring device is not helpful, because it does not address the underlying causes of the poor glycemic control. The client may also perceive this as a lack of confidence in their ability to manage their diabetes or as a criticism of their choice of device. The nurse should focus on educating the client on how to use their current device correctly and consistently, rather than suggesting a change that may not be necessary or feasible.
D) Correct - Understanding the client's daily routine helps identify factors influencing blood glucose control, such as meal timing, activity level, and stress. This information aids in creating a personalized diabetes management plan.
E) Correct - Ensuring the client uses a new insulin needle for each administration is important for preventing infection and complications. Reusing needles can affect injection site health and insulin absorption.
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Related Questions
Correct Answer is B
Explanation
A) Incorrect- While missed meals can contribute to glucose fluctuations, the abrupt onset of diabetic ketoacidosis (DKA) suggests a more immediate cause, such as insulin-related factors.
B) Correct- Diabetic ketoacidosis (DKA) occurs due to a lack of sufficient insulin, resulting in the body breaking down fat for energy and producing ketones. While all the options can contribute to DKA, the most likely cause in this scenario is administering too much insulin. This can lead to a rapid drop in blood glucose levels, causing the body to initiate ketone production for energy.
C) Incorrect- While infections can contribute to insulin resistance, they are not the most common cause of the rapid development of diabetic ketoacidosis (DKA) seen in this scenario.
D) Incorrect- Eating extra food would likely lead to higher glucose levels but wouldn't cause the rapid and severe ketone production characteristic of diabetic ketoacidosis (DKA).
Correct Answer is B
Explanation
A) Incorrect- While bedtime monitoring is important, the frequency described in this choice is not consistent with FSBG monitoring before meals.
B) Correct- Performing FSBG monitoring before each meal helps the client track her blood glucose levels before consuming food, allowing her to adjust her diet or insulin regimen if necessary.
C) Incorrect- Monitoring every two hours may be excessive and not necessary for managing gestational diabetes.
D) Incorrect- Monitoring during the night is important for glycemic control, but it doesn't specifically address the need to monitor before meals.
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