A nurse is assisting with developing a discharge plan for a client who has a new diagnosis of diabetes mellitus. The client is independent and lives alone. Which of the following interventions should the nurse plan to include?

Provide the client with 1 week's supply of insulin syringes.

Arrange for a home health nurse to visit the client daily.

Notify the family of the client's health status.

Refer the client to a diabetic support group.

Answer and Explanation

The Correct Answer is D

A. Provide the client with 1 week's supply of insulin syringes: While supplying necessary equipment is part of discharge planning, providing only a one-week supply may not be sufficient for ongoing self-management. Clients should receive instruction on obtaining refills and maintaining adequate supplies, rather than limiting to a short-term provision.

B. Arrange for a home health nurse to visit the client daily: Daily home health visits are generally reserved for clients who are dependent or unable to safely manage insulin administration or blood glucose monitoring. Since this client is independent and capable of self-care, daily visits are not necessary.

C. Notify the family of the client's health status: For an independent adult, sharing medical information with family requires client consent. Unless the client requests it, notifying family is not an appropriate routine intervention and may violate privacy regulations.

D. Refer the client to a diabetic support group: Referral to a support group provides education, emotional support, and strategies for managing diabetes independently. Participation helps the client build self-efficacy, learn practical skills, and connect with others managing the condition, making it a valuable intervention for discharge planning.

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Free Nursing Study Resources

Correct Answer is A

Explanation

A. Apply light pressure to the inner canthus just after instilling the eye drops: Applying gentle pressure to the nasolacrimal duct (punctal occlusion) prevents the medication from draining into the nasopharynx, reducing systemic absorption. This technique limits the drug’s entry into the bloodstream while maximizing local therapeutic effect in the eye.

B. Wipe the eye from the inner to the outer canthus with a sterile saline-moistened cotton ball: Wiping the eye from inner to outer canthus helps remove discharge and prevent contamination of the conjunctival sac, but it does not reduce systemic absorption of ophthalmic medications.

C. Administer the medication drops directly into the lower conjunctival sac of each eye: Placing drops in the lower conjunctival sac is standard technique for ocular administration, ensuring proper drug delivery. However, this alone does not prevent systemic absorption through the nasolacrimal duct.

D. Wait 5 min after instillation before instilling the drops in the other eye: Allowing time between eye drops prevents dilution or washout between medications in different eyes, but it does not affect systemic absorption from the nasolacrimal duct.

A. Methadone B. Meperidine C. Hydromorphone D. Fentanyl

Correct Answer is A

Explanation

A. Methadone: Methadone is a long-acting opioid agonist commonly used in the management of neonatal abstinence syndrome resulting from in utero opioid exposure. It stabilizes withdrawal symptoms by binding to mu-opioid receptors and preventing the abrupt cessation effects that occur after birth. Its longer half-life allows for controlled tapering, reducing autonomic instability, irritability, tremors, and feeding difficulties.

B. Meperidine: Meperidine is a short-acting opioid analgesic primarily used for acute pain management and is not recommended for withdrawal treatment. Its metabolite, normeperidine, can accumulate and cause neurotoxicity, including seizures, especially in neonates with immature hepatic and renal function.

C. Hydromorphone: Hydromorphone is a potent opioid analgesic used for severe pain but lacks the pharmacokinetic profile required for structured withdrawal therapy. Its shorter duration of action increases the risk of fluctuating serum levels, which may worsen withdrawal instability. It is not part of standard neonatal abstinence syndrome treatment protocols.

D. Fentanyl: Fentanyl is a highly potent, short-acting synthetic opioid typically used for anesthesia and severe acute pain. Due to its rapid onset and short duration, it does not provide the steady opioid receptor stimulation required to gradually taper withdrawal symptoms in neonates. Its potency also increases the risk of respiratory depression in this population.

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A nurse is assisting with developing a discharge plan for a client who has a new diagnosis of diabetes mellitus. The client is independent and lives alone. Which of the following interventions should the nurse plan to include?

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