A client with type 2 diabetes mellitus (DM) is admitted to the hospital for uncontrolled DM. Insulin therapy is initiated with an initial dose Isophane suspension insulin at 0800. At 1600, the client reports having diaphoresis, rapid heartbeat, and feeling shaky. Which should the nurse do first?

Assess the client's oxygen saturation level.

Determine the client's current glucose level

Give the client one-half cup of fruit juice.

Give the client skim milk and crackers.

Answer and Explanation

The Correct Answer is B

A.   While oxygen saturation is important, it's not the priority in this situation. The client's symptoms strongly suggest hypoglycemia.
B.   The client's symptoms of diaphoresis, rapid heartbeat, and shakiness are classic signs of hypoglycemia. Therefore, the first action should be to confirm this diagnosis by checking the blood glucose level.
C.   Administering glucose before confirming hypoglycemia can be dangerous. If the client is hyperglycemic, giving them sugar will worsen their condition.
D.   Providing food without confirming hypoglycemia is not appropriate.

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Correct Answer is C

Explanation

A. Chips and pretzels are high in sodium, which can contribute to fluid retention and exacerbate symptoms of CVI. While reducing sodium intake can help manage fluid retention and swelling, it is not the most direct action for promoting circulation itself. It’s more of an adjunctive measure that can support overall management of CVI but does not directly improve venous circulation.
B. Mountain biking is an intense physical activity that may not be suitable for all clients with chronic venous insufficiency, especially if they have significant symptoms or mobility issues. High-impact exercises can potentially exacerbate symptoms or lead to injury. Low-impact activities are generally recommended to improve circulation and manage CVI.
C. Elevating the lower extremities is a highly effective measure for promoting circulation in clients with chronic venous insufficiency. It helps reduce venous pressure and promotes the return of blood to the heart, thereby alleviating swelling and discomfort. This action is directly beneficial in managing CVI.
D. Restricting fluid intake to water alone does not directly address the underlying issues of venous insufficiency. While managing overall fluid intake can be part of a comprehensive plan to prevent excessive fluid retention, it is not the most direct or effective action for promoting circulation compared to elevating the legs.

A. Discard the incorrectly dialed dose and recalibrate the insulin pen. B. Save the dialed dose and prepare the correct dose using a syringe C. Assist the client to administer 24 units of the dialed dose, and waste the remainder. D. Advise the client to dial down to the correct dose, which can then be administered.

Correct Answer is A

Explanation

A. This is the safest and most accurate option. Insulin dosing is critical, and an overdose can lead to hypoglycemia, a serious condition. By discarding the incorrect dose and starting anew, the nurse ensures the client receives the precise amount of insulin prescribed.
B. This option is inefficient and increases the risk of error. It involves using two different methods for insulin administration, which can lead to confusion and potential mistakes. Additionally, it doesn't address the initial error of dialing the incorrect dose.
C. This option is extremely dangerous. Administering more insulin than prescribed can lead to severe hypoglycemia. Wasting the remaining four units does not rectify the primary issue of the overdose.

D. Insulin pens are designed for precision. Altering the dialed dose after an error can compromise the accuracy of the insulin delivery system. This method is not reliable and can lead to inaccurate dosing.

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A client with type 2 diabetes mellitus (DM) is admitted to the hospital for uncontrolled DM. Insulin therapy is initiated with an initial dose Isophane suspension insulin at 0800. At 1600, the client reports having diaphoresis, rapid heartbeat, and feeling shaky. Which should the nurse do first?

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Naxlex Comprehensive Predictor Exams

Which nursing action is most helpful in promoting circulation in a client with chronic venous insufficiency?

Correct Answer is C

Explanation

When learning to use an insulin pen, a client with diabetes dials 28 units of regular insulin instead of 24 units, the prescribed dose. Which action should the nurse take?

Correct Answer is A

Explanation

Exhibits Complete the diagram by dragging from the choices area to specify which condition the client is most likely experiencing, two actions the nurse should take to address that condition, and two parameters the nurse should monitor to assess the client's progress.

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