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A nurse is assessing a client who has diabetes mellitus type 2 and presents for a follow-up visit. Which of the following lab values is most indicative of inadequate control of their diabetes since their last primary care visit and requires further teaching?

A.

HbA1c level of 7.5% (nl. 4.4-6.4%)

B.

2-hour post-prandial blood glucose level of 122 mg/dL (nl. <120 mg/dL)

C.

Random blood glucose level of 300 mg/dL (nl. <200 mg/dL)

D.

Fasting blood glucose level of 48 mg/dL (nl. 60-110 mg/dL)

Answer and Explanation

The Correct Answer is C

A. An HbA1c level of 7.5% indicates suboptimal long-term glucose control. The target for many diabetic patients is usually below 7%, but it may not require immediate action compared to more acute indicators.
B. A 2-hour post-prandial blood glucose level of 122 mg/dL is slightly above the normal range but not significantly high. This result alone is not as indicative of inadequate control as other values.
C. A random blood glucose level of 300 mg/dL is significantly elevated and indicates poor glucose control. This value is much higher than the normal range and suggests a need for further teaching and adjustment of diabetes management.
D. A fasting blood glucose level of 48 mg/dL is low and could indicate hypoglycemia rather than inadequate control. This level requires immediate attention but does not reflect poor long-term diabetes management.
 


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Related Questions

Correct Answer is A

Explanation

A. Difficulty swallowing in a client with facial burns can indicate airway compromise due to edema and should be reported immediately as it may require urgent intervention to secure the airway.
B. While pain is a significant concern and should be managed, it is not as immediately life-threatening as potential airway obstruction.
C. A respiratory rate of 24 breaths per minute is elevated but within the range of mild tachypnea, which could be due to pain or anxiety, and is not the most urgent finding.
D. Urinary output of 25 mL/hr is below normal and indicates possible hypovolemia or kidney injury, but airway concerns take precedence in this scenario.

Correct Answer is ["33"]

Explanation

To calculate the infusion rate, we'll use the following formula:

Infusion rate (gtt/min) = (Volume to be infused (mL) / Time (min)) ) x Drop factor (gtt/mL)

First, calculate the total volume to be infused:

  • 100 mL / 30 min = 3.33 mL/min

Then, multiply the volume per minute by the drop factor:

  • 3.33 mL/min x 10 gtt/mL = 33.3 gtt/min

Therefore, the nurse should set the manual IV infusion to deliver 33 gtt/min.

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