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A nurse is caring for six clients. Which of the following clients are at risk for developing peripheral neuropathy (PN)?
(Select All that Apply.)

The client admitted with diabetic ketoacidosis (DKA)

The client admitted with sleep apnea

The client admitted with a hypertensive crisis

The client admitted for an exacerbation of Systemic Lupus Erythematosus (SLE)

The client admitted with untreated tuberculosis

The client admitted with cirrhosis secondary to chronic alcohol use

Answer and Explanation

Correct Answer : A,D,E

Choice A Reason:

The client admitted with diabetic ketoacidosis (DKA) is correct. Diabetes is a common cause of peripheral neuropathy, particularly if poorly controlled. Diabetic ketoacidosis (DKA) is a severe complication of diabetes characterized by high blood sugar levels and ketone accumulation. Prolonged uncontrolled diabetes can lead to nerve damage and peripheral neuropathy.

Choice B Reason:

The client admitted with sleep apnea is incorrect. Sleep apnea is a sleep disorder characterized by pauses in breathing or shallow breathing during sleep. While sleep apnea itself is not typically associated with peripheral neuropathy, underlying conditions such as obesity or diabetes, which are risk factors for sleep apnea, can also increase the risk of peripheral neuropathy.

Choice C Reason:

The client admitted with a hypertensive crisis is incorrect. Hypertension (high blood pressure) is not directly associated with peripheral neuropathy. However, poorly controlled hypertension can lead to vascular complications and contribute to conditions such as atherosclerosis, which may indirectly increase the risk of peripheral neuropathy.

Choice D Reason:

The client admitted for an exacerbation of Systemic Lupus Erythematosus (SLE) is correct. Systemic Lupus Erythematosus (SLE) is an autoimmune disease that can affect various organs and tissues, including the peripheral nerves. Peripheral neuropathy can occur as a complication of SLE, particularly in cases of active disease or as a result of certain medications used to treat SLE.

Choice E Reason:

The client admitted with untreated tuberculosis is incorrect. Tuberculosis (TB) is a bacterial infection caused by Mycobacterium tuberculosis. While TB itself is not typically associated with peripheral neuropathy, certain medications used to treat TB, such as isoniazid, can cause peripheral neuropathy as a side effect.

Choice F Reason:

The client admitted with cirrhosis secondary to chronic alcohol use is correct. Chronic alcohol use and cirrhosis can lead to various neurological complications, including peripheral neuropathy. Alcohol-related peripheral neuropathy often presents with sensory symptoms such as tingling, numbness, and pain in the extremities.

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Correct Answer is C

Explanation

Choice A Reason:

Placing the client on clear liquids might not be appropriate in this situation because absent bowel sounds in the lower abdominal quadrants could indicate a more serious gastrointestinal issue such as ileus or bowel obstruction. Clear liquids may exacerbate these conditions and are not sufficient to address the underlying problem. Therefore, this option is not recommended until the cause of absent bowel sounds is identified and addressed.

Choice B Reason:

Performing a hemoccult blood test is not directly relevant to the situation described. Hemoccult tests are used to detect occult (hidden) blood in stool, which can be indicative of gastrointestinal bleeding. While it's important to assess for gastrointestinal bleeding in some cases, absent bowel sounds in the lower abdominal quadrants suggest a more immediate concern related to gastrointestinal motility rather than bleeding. Therefore, this option is not the most appropriate action at this time.

Choice C Reason:

Inserting a nasogastric tube is the most appropriate action in this scenario. Absent bowel sounds in a client with a spinal cord injury can indicate neurogenic bowel dysfunction, which may lead to abdominal distention and discomfort. Inserting a nasogastric tube can help decompress the stomach and intestines, reducing the risk of complications such as aspiration and providing relief from discomfort. It can also help manage gastrointestinal complications until further assessment and interventions can be implemented.

Choice D Reason:

Forcing the intake of fluids may not be appropriate without further assessment and could potentially worsen the client's condition if there is an underlying gastrointestinal issue leading to absent bowel sounds. Additionally, forcing fluids may not address the potential issue of gastrointestinal bleeding.

A. Chronic cough B. Sputum production C. Dyspnea D. Wheezing

Correct Answer is ["A","B","C","D"]

Explanation

Choice A Reason:

Chronic cough is correct. Persistent cough is a common symptom of COPD, often occurring due to irritation and inflammation in the airways.

Choice B Reason:

Sputum production is correct. COPD patients frequently experience increased mucus production, leading to coughing up phlegm or sputum, especially in the morning.

Choice C Reason:

Dyspnea is correct. Shortness of breath or dyspnea is a hallmark symptom of COPD, particularly during physical activity or exertion, and it tends to worsen as the disease progresses.

Choice D Reason:

Wheezing occurs due to narrowed airways and increased airway resistance. It is more noticeable during expiration but can also be present during inspiration in severe cases.

Choice E Reason:

Chest tightness is incorrect. While chest tightness can occur in COPD, it is typically more associated with asthma. However, some individuals with COPD may experience chest tightness, especially during exacerbations or when airflow is significantly limited.

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A nurse is caring for six clients. Which of the following clients are at risk for developing peripheral neuropathy (PN)? (Select All that Apply.)

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Explanation

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Correct Answer is ["A","B","C","D"]

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A nurse is caring for six clients. Which of the following clients are at risk for developing peripheral neuropathy (PN)?
(Select All that Apply.)