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 C

Explanation

A. Checking the pedal pulses is important for assessing circulation, but it may not directly address the cause of the muscle spasms. In this case, addressing the electrolyte imbalance is a higher priority.

B. Requesting a relaxant might provide temporary relief for muscle spasms, but it does not address the potential underlying cause. It's important to identify and treat the root issue.

C. Correct. Severe muscle spasms in a client post-thyroidectomy could indicate hypocalcemia, as the parathyroid glands, which regulate calcium levels, can be affected during the surgery. Verifying the most recent calcium level will help determine if this is the cause.

D. Administering an oral potassium supplement addresses a different electrolyte imbalance (hypokalemia), which is not typically associated with muscle spasms following a thyroidectomy. Calcium levels are more relevant in this context.

A. Take thyroid replacement medication, as ordered. B. Watch for changes in body functioning, such as lethargy, restlessness, sensitivity to cold, and dry skin Report them to the physician, C. Recognize the signs of dehydration D. Carry injectable dexamethasone at all times. E. Report any signs and symptoms of hypoglycemia

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

Explanation

A. Take thyroid replacement medication, as ordered. This is crucial for individuals who have undergone a thyroidectomy, as they will likely need thyroid hormone replacement therapy to maintain normal thyroid function.

B. Watch for changes in body functioning, such as lethargy, restlessness, sensitivity to cold, and dry skin. Report them to the physician.

These symptoms could indicate potential issues with thyroid hormone levels and should be reported to the physician for further evaluation.

C. Recognize the signs of dehydration. This is important for overall health and can be especially relevant post-surgery. Dehydration can exacerbate other issues and slow down the healing process.

D. Carry injectable dexamethasone at all times. This is not a standard discharge instruction after a thyroidectomy. Dexamethasone may be prescribed for specific situations, but it is not a routine medication for all patients post-thyroidectomy.

E. Report any signs and symptoms of hypoglycemia. This is important because thyroidectomy can affect blood sugar levels. Monitoring for signs of hypoglycemia is crucial for the client's well-being.

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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?

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Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who is 1 day postoperative following a thyroidectomy and reports severe muscle spasms of the lower extremities. Which of the following actions should the nurse take?

Correct Answer is C

Explanation

A client is being discharged after having a thyroidectomy. Which discharge instructions are appropriate for this client? Select all that apply.

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

Explanation

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