A nurse is contributing to the care plan for a client who has recently been diagnosed with type 2 diabetes mellitus. Which of the following interventions should the nurse include in the plan? (Select all that apply.)

Choice A rationale:

Reporting a near-miss using the facility’s recommended protocol and correcting the error on the MAR is the appropriate action. A “near-miss” in healthcare is a situation where an error could have happened, but didn’t, either by chance or timely intervention. It’s crucial to report these incidents as they provide valuable information for risk management and quality improvement. By analyzing near-misses, healthcare facilities can identify potential hazards and take preventive measures to ensure patient safety. Correcting the error on the MAR is also important to prevent the same mistake from happening in the future.

Choice B rationale:

Reporting the near-miss to the next shift before the next dose is due is not the best course of action. While it’s important to communicate any potential issues to the next shift, it’s more crucial to report the incident immediately using the facility’s recommended protocol. This allows for a timely investigation and corrective action. Waiting until the next shift could delay these processes and potentially put patient safety at risk.

Choice C rationale:

Correcting the MAR error but saying nothing because nothing happened is not an appropriate response. Even though the error did not result in any harm, it’s still important to report it. Near-misses are often indicators of underlying system issues that need to be addressed. By not reporting the incident, the opportunity to improve patient safety and prevent future errors is lost.

Choice D rationale:

Notifying the pharmacy about the error they almost caused is not the most appropriate action. While it’s important to communicate with the pharmacy if they were involved in the error, the first step should always be to report the near-miss using the facility’s recommended protocol. This ensures that the incident is properly documented and investigated, and that appropriate corrective actions are taken.

Choice A rationale:

Confusion can be a symptom of Diabetic Ketoacidosis (DKA). DKA is a serious complication of diabetes that occurs when your body produces high levels of blood acids called ketones. The condition develops when your body can’t produce enough insulin. Insulin normally plays a key role in helping sugar (glucose) — a major source of energy for your muscles and other tissues — enter your cells. Without enough insulin, your body begins to break down fat as fuel. This process produces a buildup of acids in the bloodstream called ketones, eventually leading to diabetic ketoacidosis if untreated.

Choice B rationale:

Polydipsia, or excessive thirst, is another common symptom of DKA. High blood sugar levels can cause increased urination, leading to dehydration and an increased feeling of thirst.

Choice C rationale:

A rapid pulse is also a symptom of DKA. This is because the body is trying to compensate for the low amount of fluid in your blood vessels due to dehydration.

Choice D rationale:

Clammy skin is not typically a symptom of DKA. It’s more commonly associated with hypoglycemia (low blood sugar), not hyperglycemia (high blood sugar) which is what occurs in DKA1.