An adult female client with type 1 diabetes mellitus is receiving NPH insulin 35 units each morning. Which finding should the practical nurse (PN) document as evidence that the amount of insulin is inadequate? (Reference Range: Glucose [0 to 50 years: less than 140 mg/dL or less than 7.8 mmo/L]).
Consecutive evening serum glucose greater than 260 mg/dL.
States her feet are constantly cold along with feeling numb.
Reports nausea in the morning but still able to eat breakfast.
A wound on the ankle that starts to drain and becomes painful.
The Correct Answer is A
The correct answer is choice A. Consecutive evening serum glucose greater than 260 mg/dL.
Choice A rationale:
A consecutive evening serum glucose greater than 260 mg/dL indicates persistent hyperglycemia. Inadequate NPH insulin dosage may lead to consistently high blood glucose levels, which can result in various complications.
Choice B rationale:
The complaint of cold feet and numbness is not a specific indicator of inadequate insulin dosage. Neuropathy and circulation issues can occur with poorly controlled diabetes, but they are not solely indicative of inadequate insulin.
Choice C rationale:
Nausea in the morning, even with the ability to eat breakfast, does not necessarily point to inadequate insulin dosage. It could be due to various factors, including dietary choices or other medical conditions.
Choice D rationale:
The wound on the ankle that starts to drain and becomes painful is not a specific sign of inadequate insulin dosage. Poorly controlled diabetes can lead to delayed wound healing, but it does not necessarily indicate that the current insulin dosage is insufficient.
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Related Questions
Correct Answer is D
Explanation
The PN should directly observe the UAP's performance and provide feedback and guidance as needed. This can help ensure that the UAP follows the standards of care and respects the client's dignity and preferences.
The other options are not correct because:
A. Asking another UAP to help the oriented may not be appropriate or necessary, as it may interfere with the orientation process and create confusion or conflict.
B. Verifying with the client that the bath was complete and thorough may not be sufficient or reliable, as the client may not be able to assess the quality of care or may not want to complain.
C. Inspecting the client's skin near the end of the bathing procedure may not be timely or comprehensive, as it may miss some aspects of care or some problems that occurred during the bath.
Correct Answer is ["0.6"]
Explanation
Step 1: The medication is prescribed as 30 mg every 12 hours, which means it is given twice a day. So, the total daily dosage in mg is 30 mg × 2 = 60 mg.
Step 2: The medication is available in 30 mg per 0.3 mL. So, to find out how many mL correspond to 60 mg, we set up a proportion: (30 mg / 0.3 mL) = (60 mg / x mL). Solving for x gives x = (0.3 mL / 30 mg) × 60 mg = 0.6 mL.
Therefore, the practical nurse should administer 0.6 mL of the medication each day.
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