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

1 AM while sleeping: NPH insulin, like Humulin N, typically reaches its peak effectiveness about 4-12 hours after administration. Since the client takes it at 5 PM, the time of greatest risk for hypoglycemia is around 1 AM when the insulin's effects are at their peak. This is a critical period for monitoring blood glucose levels.

B. 8 PM shortly after dinner: By 8 PM, the NPH insulin's effectiveness is not at its peak. It's been about 3 hours since administration, and the insulin is still working to lower blood glucose levels. This time frame is not associated with the highest risk of hypoglycemia.

C. 6 PM shortly after dinner: At 6 PM, it's been only about an hour since the client took the NPH insulin. The insulin is just beginning to take effect, and the risk of hypoglycemia is not as high as it would be later in the night.

D. 11:00 AM, shortly before lunch: By 11:00 AM, the effects of the NPH insulin from the previous evening have largely worn off. This time frame is not associated with a high risk of hypoglycemia related to the evening dose of NPH insulin.

A. Have an eye examination once per year B. Examine your feet carefully every day C. Wear compression stockings D. "Maintain stable blood glucose level

Correct Answer is A

Explanation

A. Have an eye examination once per year - Regular eye examinations are crucial for detecting and managing retinopathy, a complication of diabetes that affects the eyes.

B. Examine your feet carefully every day - Daily foot examinations are essential to detect any early signs of foot problems, which is particularly important in preventing complications like nephropathy.

C. Wear compression stockings - Compression stockings are not directly related to preventing retinopathy and nephropathy in diabetes. They are more commonly used to improve blood flow in the legs.

D. "Maintain stable blood glucose levels" - While maintaining stable blood glucose levels is important for overall diabetes management, it is not specific to preventing retinopathy and nephropathy. It is a general principle for managing diabetes.

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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

The client with type 1 diabetes mellitus is prescribed to take NPH (Humulin N) insulin at 5 PM each day. The client should be instructed that the greatest risk of hypoglycemia will occur about what time?

Correct Answer is A

Explanation

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Correct Answer is A

Explanation

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