A nurse is caring for a client who is pregnant.

Nurses' Notes 1000:

The client reports repeated episodes of vomiting and two episodes of diarrhea in past 24 hr. Client is at 18 weeks of gestation and reports a history of nausea and vomiting for the past 12 weeks.

1015:

IV fluids initiated. Prochlorperazine administered via intermittent IV bolus.

1100:

Client reports improvement in nausea. Ice chips provided. Client voided 50 mL of dark yellow urine.

The nurse is providing discharge teaching to the client.

For each discharge instruction, specify if each action is recommended or contraindicated for the client.

Choice A rationale:

A random plasma glucose level of 176 mg/dL indicates high blood sugar at the time of the test. Random glucose levels are not ideal for assessing glycemic control as they can vary based on recent food intake and stressors.

Choice B rationale:

Triglyceride levels are not used to assess glycemic control. They measure the amount of triglycerides in the bloodstream and are related to lipid metabolism, not glucose control.

Choice C rationale:

HbA1c (glycated hemoglobin) is a long-term measure of blood glucose control. An HbA1c level of 6.8% indicates acceptable glycemic control in a person with diabetes. The normal range for HbA1c is typically less than 6.5%. This test reflects the average blood sugar level over the past 2-3 months, giving a better understanding of overall glucose control.

Choice D rationale:

Fasting blood glucose of 120 mg/dL is slightly elevated. While fasting blood glucose levels below 100 mg/dL are generally considered normal, levels between 100-125 mg/dL are considered prediabetic, and levels above 126 mg/dL on two separate occasions indicate diabetes. The result provided falls within the prediabetic range but does not indicate optimal glycemic control.

Choice A rationale:

Assisted living facilities are suitable for individuals who need assistance with activities of daily living but do not require skilled nursing care. This option might not be necessary based on the partner's exhaustion alone.

Choice B rationale:

Respite care provides temporary relief to caregivers, allowing them to take a break from their caregiving responsibilities. Given the partner's exhaustion, respite care would offer the much-needed rest, reducing caregiver burnout and ensuring better care for the client at home.

Choice C rationale:

Rehabilitation services are designed for patients who need specialized therapy after an illness or injury. While they might be beneficial for the client following a stroke, they do not directly address the partner's exhaustion and need for relief.

Choice D rationale:

Skilled nursing facilities provide 24/7 medical care for individuals with complex medical needs. The partner's exhaustion does not necessarily indicate the need for skilled nursing care, as the client's condition and care requirements were not provided in the scenario.