A nurse is reviewing guidelines to prevent DKA during periods of illness with a client who has type 1 diabetes mellitus. Which of the following instructions should the nurse include in the teaching?

"Withhold your usual daily dose of insulin."

"Drink 240 to 360 milliliters of calorie-free liquids every 8 hours."

"Test your blood glucose level every 8 hours."

"Check your urine for ketones when blood glucose levels are greater than 240 mg/dL."

Answer and Explanation

The Correct Answer is D

A. Incorrect. Withholding insulin during illness is not recommended. Clients with type 1 diabetes should continue to take their prescribed insulin even when they are ill. Insulin is necessary to regulate blood glucose levels, and illness can increase the body's demand for insulin.

B. Incorrect. Drinking calorie-free liquids is important to prevent dehydration during illness, but specific fluid amounts should be individualized based on the client's needs and healthcare provider's recommendations. The given volume is not a universally applicable guideline.

C. Incorrect. Testing blood glucose levels every 8 hours may not be frequent enough during illness. Blood glucose should be monitored more frequently to closely track changes in response to illness and adjust insulin doses accordingly.

D. Correct. Checking urine for ketones when blood glucose levels exceed 240 mg/dL is an important guideline during illness. Elevated blood glucose levels can lead to the production of ketones, and checking for ketones in the urine helps identify the early signs of diabetic ketoacidosis (DKA). If ketones are present, the client should follow a specific plan of action as outlined by their healthcare provider, which may include adjusting insulin doses or seeking medical attention.

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Correct Answer is A

Explanation

A. Correct. Propylthiouracil (PTU) is an antithyroid medication used to treat hyperthyroidism, including Graves' disease. It can sometimes cause agranulocytosis, a condition characterized by a severe reduction in white blood cells, which can lead to symptoms like a sore throat and fever. These symptoms should be reported immediately.

B. Constipation is not a common side effect of propylthiouracil. If it occurs, it is usually not an urgent concern, and can often be managed with dietary and lifestyle changes.

C. Increased urine output is not typically associated with propylthiouracil. It is more likely to be seen with diuretic medications or conditions like diabetes.

D. Painful, excessive menstruation is not a direct side effect of propylthiouracil. However, hormonal changes related to hyperthyroidism can affect menstrual patterns. If the client is experiencing significant changes in menstrual bleeding, it should be reported to the healthcare provider, but it may not be considered an immediate emergency.

A. in the morning with breakfast B. in the morning on an empty stomach with other daily meds C. in the evening with a snack D. the morning before breakfast and without any other medications

Correct Answer is B

Explanation

A. This option is not ideal for levothyroxine (Synthroid) because it should be taken on an empty stomach for optimal absorption. Taking it with food, especially a meal like breakfast, can interfere with its absorption.

B. This is the correct option. Levothyroxine should be taken in the morning, at least 30 minutes before breakfast, or any other medications. Taking it on an empty stomach ensures the best absorption of the medication.

C. Taking levothyroxine in the evening is not recommended. It should be taken in the morning to coincide with the body's natural circadian rhythm and to avoid potential interactions with food or other medications.

D. While it's important to take levothyroxine in the morning before breakfast, it is not necessary to take it without any other medications. It can be taken alongside other daily medications as long as there are no interactions that would affect its absorption.

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A nurse is reviewing guidelines to prevent DKA during periods of illness with a client who has type 1 diabetes mellitus. Which of the following instructions should the nurse include in the teaching?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Propylthiouracil (PTU) is prescribed for a client with Graves' disease. The nurse should teach the client to immediately report which of the following?

Correct Answer is A

Explanation

When preparing to provide morning medications, the nurse would give levothyroxine (Synthroid) ordered daily in which of the following ways?

Correct Answer is B

Explanation

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