A nurse is caring for a client who is receiving phototherapy for psoriasis. Which of the following findings should the nurse identify as an indication of overexposure?

A. Water pitcher on client's bedside table: Water does not require special handling after chemotherapy. The nurse should ensure that the client has access to clean drinking water, but there are no special precautions for handling it.
B. Client's urine in the bedside commode: Client's urine after chemotherapy requires special handling, as it may contain cytotoxic drugs or their metabolites for up to 48 hours. Proper precautions, such as wearing gloves and using appropriate disposal methods, are necessary to avoid exposure.
C. Client's bed linens after use: Bed linens do not require special handling unless contaminated with bodily fluids such as urine or vomit that could contain chemotherapy drugs. Gloves should be worn, but no additional precautions are required unless the linens are contaminated.
D. Food tray and utensils from client's breakfast: Food trays and utensils do not require special handling after chemotherapy unless they are contaminated with body fluids. Normal cleaning and sanitation practices are sufficient.

Rationale for Correct Answers

• How to check blood glucose at home: The client has hyperglycemia and may have undiagnosed diabetes. Teaching self-monitoring of blood glucose is essential for ongoing glycemic control, treatment adjustments, and early detection of dangerous fluctuations.
• Manifestations of hyperglycemia and hypoglycaemia: The client is already showing signs of hyperglycemia (polyuria, weight loss, fatigue). Understanding the symptoms of both high and low blood sugar helps prevent complications and allows timely self-intervention.
• Perform 100 min of physical activity per week: Moderate physical activity helps improve insulin sensitivity and blood glucose regulation. While 150 min/week is ideal, 100 min is a beneficial starting point for clients new to exercise or with complications like foot ulcers.
• Weight loss tips: The client has a BMI of 27, which falls into the overweight category. Weight loss is often beneficial for improving blood glucose control in individuals with type 2 diabetes and reducing overall health risks.

Rationale for Incorrect Answers

• Instructions on how to take metoprolol: There is no indication in the data that the client has hypertension, arrhythmia, or another condition that warrants beta-blocker therapy. Teaching this would be irrelevant unless metoprolol is newly prescribed.
• Check feet weekly on the same day each week: Clients with diabetes or suspected diabetes should be taught to inspect their feet daily, not weekly. Delayed detection of wounds or infection can lead to severe complications, including amputation.