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

Answer and Explanation

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.

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Correct Answer is D

Explanation

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.

A. In the morning with breakfast B. in the morning on an empty stomach with other daily meds C. in the evening with a snack D. In the morning before breakfast and without any other medications

Correct Answer is B

Explanation

A. Incorrect. Taking levothyroxine with breakfast may reduce its absorption due to food interference.

B. Correct. Levothyroxine should be taken in the morning on an empty stomach, at least 30 minutes before any other medications or food, to ensure optimal absorption.

C. Incorrect. Taking levothyroxine in the evening with a snack is not recommended. It should be taken on an empty stomach for best results.

D. Incorrect. Taking levothyroxine in the morning before breakfast is advised, but it should also be done on an empty stomach. Additionally, there's no need to avoid other medications if they do not interfere with its absorption.

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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?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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?

Correct Answer is D

Explanation

When preparing to provide morning medications, the nurse would give levothyroxine (Synthroid) ordered daily in which of the following ways?

Correct Answer is B

Explanation

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