A client with diabetic ketoacidosis (DKA) is receiving regular insulin. Which action should the practical nurse (PN) implement to evaluate the effectiveness of the insulin dosage?
Smell the client's breath for resolution of a fruity odor.
Determine the client's orientation to time and space.
Measure the client's urinary output for an increased volume.
Check fingerstick blood glucose for a decrease in the level.
The Correct Answer is D
Regular insulin is the medication of choice for treating DKA. Its main action is to lower blood glucose levels by promoting the uptake of glucose into cells and inhibiting the production of glucose by the liver. Therefore, checking the fingerstick blood glucose level is an important indicator of the effectiveness of the insulin treatment.
A decrease in the blood glucose level indicates that the insulin is working to lower the high blood sugar associated with DKA. This measurement helps the PN assess the response to treatment and adjust the insulin dosage if necessary.
The other actions mentioned are also important assessments in the care of a client with DKA, but they do not specifically evaluate the effectiveness of the insulin dosage:
A. Smelling the client's breath for resolution of a fruity odor is important as it indicates a decrease in ketone production, which is a marker of improving DKA. However, it does not directly evaluate the effectiveness of the insulin dosage.
B. Determining the client's orientation to time and space is part of assessing their neurological status, which is crucial in managing DKA. However, it does not specifically assess the effectiveness of the insulin dosage.
C. Measuring the client's urinary output for an increased volume is important to monitor hydration status and renal function, but it does not directly evaluate the effectiveness of the insulin dosage.
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Related Questions
Correct Answer is C
Explanation
The client's question about whether the surgical opening will be visible suggests that they have concerns or misconceptions about the upcoming fecal diversion surgery. By reviewing the client's expectations of elimination after surgery, the PN can provide accurate information and address any anxieties or concerns the client may have.
The other options are not directly related to the client's question and are not the most appropriate actions to take in this situation:
A. Determining if this is the client's first indwelling catheter is unrelated to the client's question about the visibility of the surgical opening. It may be important to assess the client's history of urinary catheter use for other purposes, but it does not address the client's immediate concern.
B. Asking the client if they finished the bowel sterilization prescription is also unrelated to the visibility of the surgical opening. While bowel sterilization may be a part of the preoperative preparation for fecal diversion surgery, it does not address the client's questions and concerns.
D. Verifying that the client had nothing by mouth (NPO) for the past 24 hours is important for general preoperative care but does not address the client's specific question about the visibility of the surgical opening.
Correct Answer is ["B","E"]
Explanation
Correct:
B- Making these changes will also help me avoid other chronic health conditions. This statement indicates an understanding because the client recognizes that the lifestyle changes discussed will not only help prevent or manage diabetes but also have a positive impact on other chronic health conditions such as cardiovascular disease and obesity.
E- If I have symptoms like increased thirst and urination, I should come in and get my blood sugar checked. This statement indicates an understanding because the client acknowledges the importance of monitoring their blood sugar levels if they experience symptoms commonly associated with diabetes, such as increased thirst and urination.
Incorrect choices:
A- If my fasting blood sugar is less than 100 next time, I can go back to my usual eating habits. This statement indicates a misunderstanding. It suggests that as long as the client's fasting blood sugar is below 100, they can resume their previous eating habits, which is not accurate. It's important to emphasize that long-term lifestyle changes are necessary, regardless of individual blood sugar readings.
C- I can never eat sugar again. This statement indicates a misunderstanding. While it's important to minimize the consumption of sugary foods and beverages, it's not necessary to completely eliminate all sugar from the diet. Moderation and mindful consumption are key.
D- If I make the changes we talked about, I will not get type 2 diabetes. This statement indicates a misunderstanding. While making positive lifestyle changes can significantly reduce the risk of developing type 2 diabetes, it does not guarantee complete prevention. Genetic and other factors can still influence an individual's susceptibility to the condition.
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