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 C
Explanation
A. Photophobia is not typically associated with hypothyroidism. It can be a symptom of conditions affecting the eyes, such as certain infections or ocular disorders.
B. Exophthalmos is a protrusion of the eyeballs and is a characteristic symptom of hyperthyroidism (overactive thyroid), not hypothyroidism (underactive thyroid).
C. Correct. Lethargy is a common symptom of hypothyroidism. It is characterized by extreme tiredness, sluggishness, and lack of energy.
D. Goiter is an enlargement of the thyroid gland and can occur in both hyperthyroidism and hypothyroidism. However, it is not a direct symptom; it is a physical finding that can be associated with thyroid disorders.
Correct Answer is B
Explanation
A. This option is not ideal for levothyroxine (Synthroid) because it should be taken on an empty stomach for optimal absorption. Taking it with food, especially a meal like breakfast, can interfere with its absorption.
B. This is the correct option. Levothyroxine should be taken in the morning, at least 30 minutes before breakfast, or any other medications. Taking it on an empty stomach ensures the best absorption of the medication.
C. Taking levothyroxine in the evening is not recommended. It should be taken in the morning to coincide with the body's natural circadian rhythm and to avoid potential interactions with food or other medications.
D. While it's important to take levothyroxine in the morning before breakfast, it is not necessary to take it without any other medications. It can be taken alongside other daily medications as long as there are no interactions that would affect its absorption.
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