A nurse is caring for a client who has uncontrolled type 1 diabetes mellitus. Which of the following findings should the nurse expect?
Weight loss
Hematuria
Bradycardia
Hypertension
The Correct Answer is A
Choice A reason:
Weight loss is a common finding in individuals with uncontrolled type 1 diabetes mellitus. Due to the lack of insulin, the body cannot utilize glucose effectively, leading to the breakdown of body fat and muscle for energy, resulting in weight loss.
Choice B reason:
Hematuria, or blood in the urine, is not a typical finding associated with uncontrolled type 1 diabetes mellitus. While diabetes can cause kidney damage over time, leading to proteinuria, hematuria would not be an expected finding solely due to uncontrolled diabetes.
Choice C reason:
Bradycardia, or a slower than normal heart rate, is not a common finding in uncontrolled type 1 diabetes mellitus. In fact, diabetes can sometimes cause autonomic neuropathy, which can affect the heart rate, but this typically does not result in bradycardia.
Choice D reason:
Hypertension is more commonly associated with type 2 diabetes mellitus, often due to insulin resistance. In type 1 diabetes, especially when uncontrolled, hypertension is not a typical finding unless there is coexisting kidney damage.
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Correct Answer is D
Explanation
Choice A reason:
While a blood glucose level of 120 mg/dL is slightly above the normal range, it is not typically considered an emergency for a client with type 2 diabetes mellitus. This client would require monitoring and potential adjustment of their diabetes management plan, but it does not necessitate immediate assessment.
Choice B reason:
For a client with diabetes insipidus, an intake of 1,500 mL and an output of 1,600 mL in 24 hours is within expected parameters, considering the condition's characteristic polyuria and polydipsia. This client would need ongoing monitoring to maintain fluid balance but is not the highest priority for immediate assessment.
Choice C reason:
A heart rate of 100/min and tremors in a client with Graves' disease could indicate that their condition is not well-controlled. However, these symptoms are not as acutely concerning as those of a stroke and would be addressed after more urgent needs are met.
Choice D reason:
A client who has had a left-sided stroke and reports a severe headache and confusion is exhibiting signs of a possible acute neurological change or complication, such as increased intracranial pressure or hemorrhage. This client requires immediate assessment and intervention due to the potential for rapid deterioration and life-threatening complications.
Correct Answer is C
Explanation
Choice A reason:
Resuming sexual intercourse in 2 to 3 weeks may not be appropriate for all patients after such a major surgery. The recovery time can vary based on individual factors, including the extent of the surgery and the patient's overall health. It's essential for patients to follow their healthcare provider's specific recommendations, which typically involve waiting until after the postoperative check-up, usually around 6 weeks, to ensure proper healing.
Choice B reason:
Increased vaginal drainage typically occurring 5 days following surgery could be a sign of infection or other complications. Normal postoperative discharge should gradually decrease over time. If a patient experiences increased drainage, especially if it's foul-smelling or accompanied by fever, they should contact their healthcare provider immediately.
Choice C reason:
After a total abdominal hysterectomy and bilateral salpingo-oophorectomy, patients may experience vaginal dryness due to decreased estrogen levels. Using artificial lubricants can help alleviate symptoms of itching and dryness, making this an appropriate instruction for postoperative care.
Choice D reason:
A Papanicolaou (Pap) test is not typically required every 6 months after a total abdominal hysterectomy and bilateral salpingo-oophorectomy for uterine cancer unless the surgery was performed as treatment for cervical cancer or serious pre-cancer. For those who had the procedure due to benign conditions, further Pap tests are generally not necessary.
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