A nurse is caring for a 72-year-old client who has type 1 diabetes mellitus.

Exhibits

Select the 3 findings that require immediate follow-up.

Glucose at 1130

Client report of shakiness

Temperature

Heart rate

SPO2

HbA1c

Answer and Explanation

Correct Answer : A,B,D

A. The fingerstick blood glucose level of 55 mg/dL at 1130 indicates hypoglycemia, which requires immediate attention to prevent further complications such as loss of consciousness or severe symptoms.
B. The client's report of shakiness, hunger, and cool, diaphoretic skin are signs of hypoglycemia, especially given the low blood glucose level. This requires prompt intervention to manage the blood glucose level.
C. The temperature of 37.8 °C (100 °F) is slightly elevated but does not require immediate follow-up unless there are other symptoms of infection or significant changes.
D. The elevated heart rate of 118/min could indicate an underlying issue such as dehydration, hypoglycemia, or infection. It requires further evaluation in the context of other findings.
E. The SpO2 of 95% on room air is within an acceptable range and does not require immediate follow-up unless there are other signs of respiratory distress or worsening condition.
F. The HbA1c of 8.01% reflects long-term glucose control but is not an immediate concern for follow-up in the acute setting. It is important for overall management but not an urgent issue for this particular scenario.

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Correct Answer is A

Explanation

A. Clay-colored stools are indicative of a bile duct obstruction because bile is not reaching the intestines, leading to pale or clay-colored stools.
B. Tenderness in the left upper abdomen is more commonly associated with issues such as splenic or gastric problems rather than a bile duct obstruction.
C. Ecchymosis of the extremities is not typically associated with bile duct obstruction. It might indicate other issues such as bleeding disorders.
D. Straw-colored urine is not indicative of bile duct obstruction; typically, the urine would appear darker due to elevated bilirubin levels from bile duct obstruction.

A. Monitor for symptoms of anemia B. Expect an increase in appetite while on the medication C. Rotate the site of the patch application D. Anticipate relief of symptoms in 1-2 weeks

Correct Answer is A

Explanation

A. Monitoring for symptoms of anemia is essential as methotrexate can cause bone marrow suppression, leading to anemia. The nurse should instruct the client to report symptoms like fatigue, pallor, and shortness of breath.
B. Methotrexate is more likely to cause gastrointestinal side effects like nausea and loss of appetite rather than an increase in appetite.
C. Methotrexate is typically administered orally or by injection, not via a patch, so rotating the site of patch application is not relevant.
D. Relief of symptoms from methotrexate generally takes several weeks to months. It is important to set realistic expectations about the timeline for symptom improvement.

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A nurse is caring for a 72-year-old client who has type 1 diabetes mellitus. Exhibits Select the 3 findings that require immediate follow-up.

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A nurse is caring for a 72-year-old client who has type 1 diabetes mellitus.

Exhibits

Select the 3 findings that require immediate follow-up.