A nurse is teaching a client with diabetes mellitus about chronic complications associated with the disease. Which information should be included in the teaching?
Ensure adequate fluid intake to prevent kidney damage
Schedule and keep appointments for annual eye exams
Podiatry exams are necessary every 3 months
Excessive exercise increases insulin resistances
Correct Answer : B,C
A. While maintaining adequate hydration is important for overall health and can help the kidneys function properly, this statement alone does not capture the full scope of kidney-related issues associated with diabetes, such as diabetic nephropathy. It’s important to emphasize regular monitoring of kidney function through lab tests (e.g., microalbuminuria) as part of diabetes management.
B. People with diabetes are at increased risk for eye complications such as diabetic retinopathy, cataracts, and glaucoma. Regular eye exams are essential for early detection and management of these conditions, making this information critical for a client with diabetes.
C. Many sources recommend at least annual foot exams, but those with neuropathy or previous foot problems may need more frequent evaluations (every 3 to 6 months). This statement is generally accurate but should be tailored to the individual's risk factors.
D. Regular physical activity is generally recommended for individuals with diabetes as it improves insulin sensitivity, helping to manage blood glucose levels. While extreme exercise without proper management can lead to complications, stating that excessive exercise increases insulin resistance is misleading. The key is to balance exercise with proper nutrition and medication.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","B","D","E"]
Explanation
A. Infections, including urinary tract infections, can increase insulin resistance and elevate blood glucose levels, potentially leading to DKA. The stress response from infection can also increase cortisol levels, further contributing to hyperglycemia.
B. Decreased caloric intake can lead to inadequate insulin levels relative to the body’s needs. In Type 1 diabetes, if insulin is not sufficient to metabolize glucose (due to low intake or other reasons), the body may resort to fat metabolism, leading to the production of ketones and the development of DKA.
C. While exercise can affect blood glucose levels, it typically lowers them and is not a direct cause of DKA. In fact, moderate aerobic exercise is usually encouraged for managing diabetes. However, if blood glucose levels are already high before exercise, it may exacerbate the situation, but aerobic exercise itself is not a cause of DKA.
D. Clogged tubing can prevent insulin delivery, leading to insufficient insulin levels. This lack of insulin can result in elevated blood glucose levels and, ultimately, the risk of DKA if not addressed.
E. Not taking enough insulin is a primary cause of DKA in Type 1 diabetes. Without adequate insulin, the body cannot utilize glucose properly, leading to increased fat metabolism and the production of ketones, which can cause DKA.
Correct Answer is ["A","C"]
Explanation
A. The nurse should notify the prescriber about the current dose (7 mL/hr) because the patient is ordered 1600 units of heparin per hour. The current infusion rate needs to be assessed in relation to the aPTT result, especially if the aPTT indicates that the patient may be at risk for bleeding.
B. While having a second IV may be useful for administering fluids or medications in case of a bleeding emergency, there is no immediate indication for IV 0.9 saline in this scenario. The priority is to assess the heparin dosage and aPTT before making additional IV arrangements.
C. It’s important to assess the IV site for signs of infiltration, especially since the patient is on heparin therapy. Infiltration can affect the effectiveness of the medication and cause complications, so this assessment is vital.
D. While it is important to verify lab results, the nurse should primarily focus on addressing the current situation regarding the heparin infusion and the patient’s anticoagulation status rather than confirming lab results with the lab technician at this moment.
E. While protamine sulfate is an antidote to heparin, it is not warranted based solely on the aPTT result of 37 seconds. The normal aPTT range is typically around 30-40 seconds, depending on the laboratory standards, and the aPTT may not indicate that the patient requires reversal of heparin at this time.
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