A nurse is teaching an older adult client who has diabetes mellitus about preventing the long term complications of retinopathy and nephropathy. Which of the following instructions should the nurse include?
Have an eye examination once per year
Examine your feet carefully every day
Wear compression stockings
"Maintain stable blood glucose level
None
None
The Correct Answer is D
A. While a yearly dilated eye examination is crucial for the early detection and management of diabetic retinopathy, this action alone only addresses one of the two complications mentioned in the prompt. It does not prevent the development of nephropathy.
B. Examining the feet carefully every day is a vital preventive measure for diabetic neuropathy and peripheral vascular disease to avoid foot ulcers and infections. However, daily foot checks do not prevent microvascular damage to the eyes or kidneys.
C. Compression stockings are used to manage venous insufficiency or peripheral edema, but they are not standard preventative therapy for diabetic retinopathy or nephropathy, and tight hosiery may even be contraindicated if the client has co-existing peripheral arterial disease.
D. Maintaining stable, optimal blood glucose levels is the most effective primary intervention to prevent both retinopathy and nephropathy. Chronic hyperglycemia causes microvascular damage to the small blood vessels in both the retina and the renal glomeruli; therefore, strict glycemic control slows the onset and progression of both conditions simultaneously.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. Administering aspirin for hyperthermia is not a standard intervention for hyperthyroidism. Hyperthermia can occur in severe cases of hyperthyroidism, but the primary intervention is to address the underlying thyroid dysfunction and provide supportive care.
B. Keeping the client NPO (nothing by mouth) is not directly related to preventing a thyroid crisis in hyperthyroidism. It may be necessary for certain pre-operative preparations or if the client is undergoing specific procedures, but it does not address the prevention of a thyroid crisis.
C. While monitoring for signs of hypocalcemia is important in some cases of thyroid dysfunction, it is not the primary action to prevent a thyroid crisis. In hyperthyroidism, the focus is on managing excessive thyroid hormone levels.
D. Correct. Providing a quiet, low-stimulus environment is a crucial nursing intervention for clients with hyperthyroidism. They can be highly sensitive to external stimuli due to their increased metabolic rate. A calm environment helps reduce stress and the risk of exacerbating symptoms, potentially preventing a thyroid crisis.
Correct Answer is ["4"]
Explanation
Dose (mg) / Concentration (mg/mL) = Volume (mL)
Plugging in the given values, we get:
40 mg / 10 mg/mL = 4 Ml
Therefore, the nurse should administer 4 mL of furosemide per dose.
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