Exhibits
Nursing actions: Indicated/contraindicated/non-urgent
Teach the client how to count carbohydrates
Stop the insulin infusion
Decrease the frequency of blood glucose tests
Start the client on a regular diet
Decrease the insulin IV infusion to 0.05 units/kg/hr
The Correct Answer is {"A":{"answers":"C"},"B":{"answers":"B"},"C":{"answers":"B"},"D":{"answers":"B"},"E":{"answers":"A"}}
A. Teach the client how to count carbohydrates - Non-urgent. While essential for long- term management of diabetes, carbohydrate counting is not immediately critical in the acute management phase of HHS in the ICU. This teaching should be delayed until the patient is stabilized.
B. Stop the insulin infusion - Contraindicated. Stopping insulin in a patient with HHS, which is characterized by severe hyperglycemia, would be harmful. Insulin therapy is critical to reduce blood glucose levels safely.
C. Decrease the frequency of blood glucose tests - Contraindicated. Frequent monitoring is crucial in managing HHS, especially when insulin therapy is being administered, to prevent hypoglycemia and to monitor the effectiveness of treatment.
D. Start the client on a regular diet - Contraindicated. Introducing a regular diet during the acute phase of HHS could exacerbate the hyperglycemia. Nutritional needs should be assessed and managed carefully, typically starting with IV fluids and gradually transitioning to enteral or oral feeding as the patient stabilizes.
E. Decrease the insulin IV infusion to 0.05 units/kg/hr- Indicated. As blood sugar levels decrease, the insulin infusion rate may be cautiously reduced to prevent hypoglycemia.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. Involving another nurse might not necessarily address the client's guarded and suspicious behavior.
B. Documenting the behavior is important for the client's records, but it doesn't address the immediate need for assessment.
C. Postponing the interview might not resolve the client's guarded behavior and could delay necessary assessment.
D. Attempting to ask the client simple questions allows for a non-threatening approach and might gradually build rapport, encouraging the client to engage in conversation.
Correct Answer is D
Explanation
A: Osmolality measures the concentration of solutes in the blood and is not typically affected by naproxen or indicative of the reported symptoms.
B: While naproxen can cause gastrointestinal irritation and ulceration, it does not typically affect serum calcium levels. Monitoring serum calcium would not directly address the client's reported symptoms.
C: ESR is a nonspecific marker of inflammation and is not directly related to the reported symptoms of stomach pain, weakness, and fatigue associated with naproxen use.
D: Naproxen, a nonsteroidal anti-inflammatory drug (NSAID), can cause gastrointestinal bleeding, which may lead to anemia and a decrease in hemoglobin levels. Monitoring hemoglobin levels can help assess for gastrointestinal bleeding in this client who is experiencing stomach pain and weakness/fatigue.
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