A nurse is reinforcing teaching with a client who has type 2 diabetes mellitus. The nurse determines that teaching has been effective when the client identifies which of the following manifestations of hypoglycemia? (Select all that apply.)

Choice A reason: Wearing closed-toed shoes daily is a good practice for people with diabetes, as it can protect the feet from injuries and infections. However, it is not the most important action for preventing long-term complications of retinopathy and neuropathy. These complications are mainly caused by high blood glucose levels that damage the blood vessels and nerves in the eyes and feet.

Choice B reason: Maintaining stable blood glucose levels is the most important action for preventing long-term complications of retinopathy and neuropathy. High blood glucose levels can cause oxidative stress, inflammation, and endothelial dysfunction, which impair the blood flow and oxygen delivery to the eyes and feet. This can lead to nerve damage (neuropathy) and vision loss (retinopathy) over time. Keeping blood glucose levels within the target range can reduce the risk of these complications and slow down their progression if they already exist.

Choice C reason: Planning to have an eye examination once per year is a recommended action for people with diabetes, as it can help detect and treat retinopathy before it causes irreversible damage to the retina. However, it is not the most important action for preventing long-term complications of retinopathy and neuropathy. Eye examinations cannot prevent retinopathy from occurring or worsening; they can only monitor its status and provide appropriate interventions.

Choice D reason: Examining your feet carefully every day is another recommended action for people with diabetes, as it can help identify and treat any signs of neuropathy, such as numbness, tingling, pain, or ulcers. However, it is not the most important action for preventing long-term complications of retinopathy and neuropathy. Foot examinations cannot prevent neuropathy from occurring or worsening; they can only monitor its status and provide appropriate care.

Choice A: Blurred vision is not a typical finding of hypothyroidism. It can be caused by other conditions, such as diabetes, glaucoma, or eye strain.

Choice B: Bradycardia is a slow heart rate, usually below 60 beats per minute. This is a common finding of hypothyroidism, as the thyroid hormone regulates the metabolic rate and affects the cardiovascular system. Low levels of thyroid hormone can cause the heart to beat slower and weaker.

Choice C: Insomnia is difficulty falling or staying asleep. This is not a common finding of hypothyroidism, as low thyroid hormone levels can cause fatigue, lethargy, and excessive sleepiness.

Choice D: Moist skin is not a common finding of hypothyroidism, as low thyroid hormone levels can cause dry skin, hair loss, and britle nails. Moist skin can be a sign of hyperthyroidism, which is the opposite condition of hypothyroidism.