A nurse is reviewing the electronic health record (EHR) of a client who has type 2 diabetes mellitus. Which of the following findings in the client EHR should the nurse identify as a risk factor for type 2 diabetes mellitus?

A. Apply the gown before the gloves: The gown must be applied before donning gloves to ensure that the gown fully covers the arms and torso, providing a protective barrier against contamination. Gloves are then pulled over the gown cuffs to maintain a proper seal and reduce the risk of pathogen exposure, especially with infections like Clostridium difficile.

B. The gown with the gloves on: Wearing the gown after gloves compromises the sterile barrier, allowing pathogens to contact the skin or clothing. This technique increases the risk of contamination because the gloves may not completely cover or seal the gown’s cuffs properly, which is critical in preventing the spread of infection.

C. Tuck the glove cuffs under the gown sleeves: Gloves should not be tucked under gown sleeves. Instead, gloves should cover the gown cuffs, creating a continuous protective layer. Tucking gloves under the gown can leave the wrists exposed and vulnerable to contamination, particularly when caring for clients with highly transmissible infections.

D. Push the gown sleeves up to the elbows: Pushing the sleeves up to the elbows defeats the protective purpose of the gown. It exposes the forearms to potential pathogens and bodily fluids, increasing the risk of infection transmission to both the nurse and other clients, especially when dealing with spore-forming bacteria like Clostridium difficile.

A. BMI 32: A BMI of 30 or higher indicates obesity, which is a major risk factor for developing type 2 diabetes mellitus. Excess body fat, especially abdominal fat, contributes to insulin resistance, increasing the likelihood of diabetes.

B. Alcohol use: While excessive alcohol intake can affect overall health, moderate alcohol consumption is not a primary direct risk factor for type 2 diabetes. Other factors like obesity and sedentary lifestyle have a stronger association.

C. Age 35 years: Advancing age increases diabetes risk, but significant age-related risk typically rises after age 45. At 35 years old, age alone is not considered a major risk factor without additional contributing conditions.

D. Medical history of asthma: Asthma is a chronic respiratory condition but is not recognized as a risk factor for type 2 diabetes mellitus. The primary risk factors involve metabolic, genetic, and lifestyle components rather than respiratory history.