A client with type 2 diabetes mellitus (DM) is being discharged after treatment for an acute bronchitis infection. The nurse is providing teaching for medications to be taken at home, which includes a new prescription for self-administered glargine insulin 20 units SUBQ at bedtime. The client asks if they now have type 1 diabetes mellitus. How should the nurse respond?
Offer support while explaining that acute illness can change the type of diabetes and its treatment.
Advise the client that the insulin will be discontinued when the glycosylated haemoglobin A1C levels reflect good control.
Remind the client that DM is a chronic progressive disease and lifelong insulin is usually needed.
Explain that the insulin injections will probably be discontinued once stress and illness are resolved.
The Correct Answer is D
Choice A reason: While acute illness can affect diabetes management and treatment, it does not change the type of diabetes. This response might confuse the client more, as type 1 and type 2 diabetes are different conditions.
Choice B reason: Advising the client that insulin will be discontinued when glycosylated haemoglobin A1C levels reflect good control can be misleading. While good control might reduce the need for insulin, the primary reason for insulin use here is the stress and illness, not just A1C levels.
Choice C reason: Reminding the client that diabetes mellitus is a chronic progressive disease and lifelong insulin is usually needed is not accurate for type 2 diabetes. Many clients with type 2 diabetes can manage their condition without lifelong insulin therapy.
Choice D reason: Explaining that insulin injections will probably be discontinued once stress and illness are resolved is accurate and helps the client understand that the need for insulin is likely temporary due to the acute condition and stress on their body. This response provides clarity and reassurance without causing unnecessary concern.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["C","D","E"]
Explanation
Choice A reason: Skin elasticity is not an immediate indicator of the client's response to diuretic treatment. It is more commonly used to assess hydration status and overall skin condition rather than the effectiveness of a diuretic.
Choice B reason: Pain scale is important for assessing the client's comfort level, but it does not directly measure the effectiveness of furosemide in improving respiratory status and reducing fluid overload.
Choice C reason: Lung sounds should be assessed to determine if there is an improvement in the client's respiratory status after the administration of furosemide. Reduction in wheezes and crackles would indicate decreased fluid in the lungs and improved breathing.
Choice D reason: Oxygen saturation is crucial to monitor as it provides information on the client's oxygenation status. An improvement in oxygen saturation levels indicates effective relief of pulmonary congestion and better gas exchange after the diuretic treatment.
Choice E reason: Urinary output is a direct measure of the effectiveness of furosemide, as it promotes diuresis to remove excess fluid from the body. Increased urinary output indicates that the medication is working to reduce fluid overload.
Correct Answer is C
Explanation
Choice A reason: Respiratory acidosis is characterized by a low pH and an elevated PaCO2 due to hypoventilation, which results in CO2 retention. The ABG results in this case show a normal PaCO2, making this option incorrect.
Choice B reason: Metabolic acidosis is characterized by a low pH and a low HCO3 due to an accumulation of acids or loss of bicarbonate. The ABG results show a high pH and a high HCO3, which are opposite to the findings of metabolic acidosis.
Choice C reason: Metabolic alkalosis is characterized by a high pH and an elevated HCO3. This condition can result from excessive loss of stomach acid due to vomiting or the use of diuretics. The ABG results show a pH of 7.50 and HCO3 of 33 me/L, both indicative of metabolic alkalosis.
Choice D reason: Respiratory alkalosis is characterized by a high pH and a low PaCO2 due to hyperventilation, which leads to CO2 loss. The ABG results show a normal PaCO2, ruling out respiratory alkalosis as the correct diagnosis.
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