A patient taking somatropin growth hormone needs to be educated on signs and symptoms of hyperglycemia. What will the nurse include in this teaching? SELECT ALL THAT APPLY
Excessive urination
Excessive thirst
Diaphoresis
Atrial fibrillation
Excessive hunger
Correct Answer : A,B,E
Choice A reason: Excessive urination is a sign of hyperglycemia because the body tries to flush out the excess glucose in the blood through the urine. This can also lead to dehydration and electrolyte imbalance.
Choice B reason: Excessive thirst is a sign of hyperglycemia because the body loses fluid and becomes dehydrated due to frequent urination. The thirst mechanism is activated to replenish the fluid loss.
Choice C reason: Diaphoresis is not a sign of hyperglycemia, but rather a sign of hypoglycemia (low blood sugar). Hypoglycemia can cause sweating, shakiness, anxiety, and confusion.
Choice D reason: Atrial fibrillation is not a sign of hyperglycemia, but rather a possible complication of hyperglycemia. Hyperglycemia can damage the blood vessels and the heart, increasing the risk of arrhythmias, such as atrial fibrillation.
Choice E reason: Excessive hunger is a sign of hyperglycemia because the body is unable to use the glucose in the blood for energy. The cells are starved of fuel, and the hunger signal is triggered to stimulate food intake..
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason: This choice is correct because blood glucose is the priority assessment for a client with a prescription for glipizide who is confused, diaphoretic, and tachycardic. Glipizide is a medicine that lowers blood sugar levels in the body. It can cause side effects such as anxiety, diarrhea, nausea, and low blood sugar. Low blood sugar (hypoglycemia) can cause confusion, sweating, fast heart rate, dizziness, hunger, and seizures. The nurse should check the client's blood glucose level and treat hypoglycemia as soon as possible.
Choice B reason: This choice is incorrect because apical heart rate is not the priority assessment for a client with a prescription for glipizide who is confused, diaphoretic, and tachycardic. Apical heart rate is the number of heartbeats per minute that can be heard at the apex of the heart. It can be affected by many factors, such as age, activity, stress, and medication. Tachycardia is a condition where the heart beats faster than normal, which can be a sign of low blood sugar, dehydration, infection, or heart problems. The nurse should check the apical heart rate after assessing and treating the blood glucose level.
Choice C reason: This choice is incorrect because INR level is not the priority assessment for a client with a prescription for glipizide who is confused, diaphoretic, and tachycardic. INR stands for international normalized ratio, which is a measure of how long it takes the blood to clot. It is used to monitor the effect of anticoagulant drugs, such as warfarin, that prevent blood clots. Glipizide does not affect the INR level, and the client's symptoms are not related to bleeding or clotting. The nurse should check the INR level only if the client is taking anticoagulant drugs and has signs of bleeding or clotting.
Choice D reason: This choice is incorrect because the last bowel movement is not the priority assessment for a client with a prescription for glipizide who is confused, diaphoretic, and tachycardic. The last bowel movement is the time and nature of the client's most recent defecation. It can be affected by many factors, such as diet, fluid intake, activity, medication, and bowel habits. Glipizide can cause diarrhea or constipation, which can affect the frequency and consistency of the bowel movement. The nurse should check the last bowel movement after assessing and treating the blood glucose level.
Correct Answer is B
Explanation
Choice A reason: This is incorrect because 30 minutes is too long to wait for reassessing a client with chest pain. Nitroglycerin has a rapid onset of action and should relieve chest pain within 5 minutes. If not, the client may need another dose or emergency care.
Choice B reason: This is correct because 5 minutes is the appropriate time to reassess a client after administering nitroglycerin sublingual. The nurse should check the client's blood pressure, heart rate, and pain level. If the pain persists, the nurse should follow the protocol for giving another dose or calling for help.
Choice C reason: This is incorrect because 1 hour is too long to wait for reassessing a client with chest pain. Nitroglycerin has a short duration of action and may need to be repeated every 5 minutes for up to 3 doses. Waiting for an hour may put the client at risk of worsening cardiac ischemia or infarction.
Choice D reason: This is incorrect because 15 minutes is too long to wait for reassessing a client with chest pain. Nitroglycerin should have an effect within 5 minutes. If the pain is not relieved by then, the client may need another dose or emergency care.
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