After years of struggling with weight management, a middle-aged adult client is evaluated for gastroplasty.
The client has experienced difficulty with managing diabetes mellitus and hypertension, but is approved for surgery.
Which intervention is most important for the nurse to include in this client’s plan of care?

Choice A rationale

Reassuring the client that the nurse will return after all vital signs are taken might not be the most appropriate action in this situation. The client is critically ill and might need immediate emotional support.

Choice B rationale

Pulling up a chair and sitting beside the client’s bed is the most appropriate action. This action shows empathy and provides emotional support, which is crucial in the care of critically ill patients.

Choice C rationale

Allowing the client to hold the nurse’s hand until the vital signs can be completed might provide some comfort to the client. However, it might not be feasible if the nurse needs to use both hands to complete the vital signs.

Choice D rationale

Telling the client that he must release the nurse’s hand might not be the most appropriate action. It might come across as dismissive and could potentially upset the client.

Choice A rationale

Exenatide is a medication used to improve blood sugar control in adults with type 2 diabetes. One of the potential side effects of exenatide is pancreatitis, which can cause severe abdominal pain. Therefore, patients should be instructed to notify their healthcare provider if they start having abdominal pain after starting exenatide.

Choice B rationale

Exenatide should be injected within 60 minutes (1 hour) before the morning and evening meal (or before the two main meals of the day, at least 6 hours apart), not 30 minutes before or after a meal. Therefore, this instruction is incorrect.

Choice C rationale

Exenatide does not act in the same way as insulin. While both insulin and exenatide help to control high blood sugar, they work in different ways. Insulin allows sugar in your blood to enter your cells, while exenatide works by increasing the release of insulin when blood sugar levels are high, decreasing the amount of glucose produced and released by the liver, and slowing gastric emptying.

Choice D rationale

There are precautions about taking exenatide with other medications. For example, exenatide may affect the absorption of some orally administered drugs due to its effect on gastric emptying. Therefore, patients should be advised to take oral medications that require rapid absorption at least 1 hour before injecting exenatide.