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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Free Nursing Study Resources

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.

A. Glucocorticoid medications B. Oral hypoglycemic medications C. Dextrose 5% in 0.45% sodium chloride D. 0.9% sodium chloride

Correct Answer is D

Explanation

A. Glucocorticoid medications are not the primary treatment for diabetic ketoacidosis (DKA). They may be used in specific situations, but they are not the first-line treatment.

B. Oral hypoglycemic medications are not appropriate for a client with DKA. DKA is a serious condition that requires prompt treatment with insulin and intravenous fluids.

C. Dextrose 5% in 0.45% sodium chloride is not the initial treatment for DKA. This solution contains dextrose, which would raise the blood glucose levels, but it does not provide the necessary insulin to address the underlying issue of insulin deficiency.

D. Correct. The initial treatment for DKA involves administering intravenous fluids, typically with 0.9% sodium chloride (normal saline). This helps to restore blood volume, correct electrolyte imbalances, and gradually lower the high blood glucose levels. Insulin is also administered concurrently to address the underlying insulin deficiency.

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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 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

A nurse in an emergency department is caring for a client who has diabetic ketoacidosis (DKA) and a blood glucose level of 925 mg/dL. The nurse should anticipate which of the following prescriptions from the provider?

Correct Answer is D

Explanation

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