A client with type 1 diabetes mellitus calls the home care nurse and reports taking a morning dose of 70/30 insulin before realizing they have a stomach virus and are now unable to eat breakfast due to nausea. Which initial instruction should the nurse provide the client?
Drink regular colas frequently throughout the day until the nausea subsides.
Do not inject any additional insulin until solid food can be tolerated.
Go to the emergency room as soon as possible for glucose administration.
Continue to monitor blood glucose levels and drink fluids as tolerated.
The Correct Answer is D
Choice A reason: Drinking regular colas can lead to fluctuations in blood glucose levels and is not an appropriate recommendation for managing nausea in a client with diabetes.
Choice B reason: Not injecting additional insulin until solid food can be tolerated is not advisable, as it may lead to hyperglycaemia or diabetic ketoacidosis. Insulin needs to be managed carefully even if the client is not eating.
Choice C reason: Going to the emergency room immediately may not be necessary if the client can manage their blood glucose levels at home with proper guidance.
Choice D reason: Monitoring blood glucose levels and drinking fluids as tolerated is the best initial advice. This helps prevent dehydration and maintain glucose control while dealing with the nausea. The client should also follow sick day management guidelines for diabetes and stay in touch with their healthcare provider.
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Related Questions
Correct Answer is C
Explanation
Choice A reason: Lung sounds are important to assess for signs of fluid in the lungs, such as crackles, which can occur with fluid volume overload. However, they do not directly measure fluid balance.
Choice B reason: Turgor assesses skin elasticity and hydration status, but it is not the most accurate indicator of overall fluid balance in the context of fluid volume overload.
Choice C reason: Weight is the most accurate and direct measure of fluid balance. Daily weight monitoring can track changes in fluid status, as weight fluctuations can reflect gains or losses in body fluid.
Choice D reason: Blood pressure is important to monitor, especially in clients with fluid volume issues, but it is not the most direct measure of fluid balance. Weight changes provide more precise information about fluid status.
Correct Answer is C
Explanation
Choice A reason: A haematocrit of 30% is below the normal range and indicates anaemia, which is common in hypothyroidism. However, it does not require immediate intervention compared to a decline in consciousness.
Choice B reason: Facial puffiness and periorbital enema are common signs of hypothyroidism but do not require immediate intervention. They are more indicative of chronic, rather than acute, issues.
Choice C reason: A further decline in level of consciousness is critical and warrants immediate action. It can indicate a myxoedema coma, a severe complication of hypothyroidism that is life-threatening and requires urgent treatment.
Choice D reason: Cold and dry skin is a common symptom of hypothyroidism but does not require immediate intervention compared to a decline in consciousness.
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