A nurse is providing teaching to the guardians of a newborn about measures to prevent sudden infant death syndrome (SIDS). Which of the following guardian statements indicates an understanding of the teaching?

• A. Incorrect. Withholding pain medications for 24 hr after the old patch is removed is a harmful action that could cause severe withdrawal symptoms and uncontrolled pain for the client. The nurse should respect the client's right to refuse treatment and explore the reasons for their decision.
• B. Correct. Asking another nurse to witness the disposal of the new patch is a safe and legal action that follows the policies and procedures for handling controlled substances. The nurse should document the disposal of the new patch and report it to the appropriate authority.
• C. Incorrect. Sealing the patches in a plastic bag and placing them in the client's trash basket is an unsafe and illegal action that could lead to diversion, misuse, or accidental exposure of fentanyl to others. The nurse should dispose of the patches in a secure and designated container that prevents access by unauthorized persons.
• D. Incorrect. Sticking the two patches to each other and placing them in the sharps bin is an unsafe and improper action that could cause contamination, injury, or infection to others who handle or dispose of sharps waste. The nurse should dispose of the patches separately and carefully, avoiding contact with their adhesive surfaces.

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.