Teaching a patient who has hyperosmolar hyperglycemic syndrome (HHS). Which of the following topics should be prioritized?
The nurse is caring for a patient with type 2 diabetes mellitus who has been prescribed doses of insulin.
Monitoring blood glucose levels
Recognizing signs and symptoms of HHS
Administering insulin correctly
Understanding the importance of hydration
Managing diet and nutrition
The Correct Answer is B
Choice A Reason:
Monitoring blood glucose levels is crucial for managing diabetes, but in the context of hyperosmolar hyperglycemic syndrome (HHS), recognizing the signs and symptoms is more critical. HHS is a serious condition characterized by extremely high blood sugar levels without significant ketoacidosis. Early recognition of symptoms such as extreme thirst, frequent urination, confusion, and weakness can prevent complications and prompt timely medical intervention.
Choice B Reason:
Recognizing signs and symptoms of HHS is the most important topic to prioritize. HHS can develop gradually and may be life-threatening if not identified and treated promptly. Patients and caregivers need to be aware of the warning signs to seek immediate medical attention. Symptoms include severe dehydration, altered mental status, and very high blood glucose levels. Educating patients on these signs ensures they can act quickly to prevent severe outcomes.
Choice C Reason:
Administering insulin correctly is essential for managing diabetes, but it is not the top priority in the context of HHS education. While proper insulin administration helps control blood glucose levels, the immediate concern in HHS is recognizing the condition’s onset. Once HHS is identified, insulin administration becomes part of the treatment plan, but early detection is key to preventing severe complications.
Choice D Reason:
Understanding the importance of hydration is important because dehydration is a significant component of HHS. Patients with HHS often experience severe dehydration due to high blood glucose levels leading to osmotic diuresis. Educating patients on maintaining adequate hydration can help manage their condition and prevent the onset of HHS. However, recognizing the symptoms of HHS remains the top priority.
Choice E Reason:
Managing diet and nutrition is a fundamental aspect of diabetes care, but it is not the primary focus when dealing with HHS. While a balanced diet helps maintain stable blood glucose levels, the immediate concern in HHS is identifying and responding to the condition’s symptoms. Once HHS is recognized and treated, dietary management becomes part of the long-term care plan.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A Reason:
The adrenal glands play a crucial role in responding to low blood glucose levels by releasing epinephrine (adrenaline) and norepinephrine. These hormones help to increase blood glucose levels by stimulating glycogenolysis (the breakdown of glycogen to glucose) and gluconeogenesis (the production of glucose from non-carbohydrate sources) in the liver. This response is part of the body’s fight-or-flight mechanism, which ensures that sufficient glucose is available for immediate energy needs.
Choice B Reason:
The liver does not release glucagon; rather, it responds to glucagon, which is released by the pancreas. Glucagon stimulates the liver to convert stored glycogen into glucose (glycogenolysis) and to produce glucose from non-carbohydrate sources (gluconeogenesis). This process helps to raise blood glucose levels when they are low.
Choice C Reason:
Glycogenesis is the process of converting glucose into glycogen for storage, and it occurs primarily in the liver and muscle cells, not in the pancreas. The pancreas releases insulin to promote glycogenesis when blood glucose levels are high, but it does not perform glycogenesis itself.
Choice D Reason:
The brain primarily uses glucose for energy and does not switch to using protein unless glucose levels are extremely low and prolonged. In such cases, the brain can use ketone bodies derived from fat as an alternative energy source. Protein is not a primary energy source for the brain under normal conditions.
Correct Answer is D
Explanation
Choice A reason: Hypertension is not directly caused by hypokalemia. While potassium levels can influence blood pressure, hypokalemia is more critically associated with cardiac issues rather than hypertension alone.
Choice B reason: Ketosis is a metabolic state resulting from the body burning fat for fuel instead of carbohydrates. It is not directly related to hypokalemia. Hypokalemia does not cause ketosis, and monitoring for ketosis in a client with hypokalemia is not a priority.
Choice C reason: Insulin resistance is a condition where the body’s cells do not respond properly to insulin. While potassium levels can affect insulin secretion and action, hypokalemia is not primarily associated with insulin resistance. Therefore, it is not the main concern for a nurse monitoring a client with hypokalemia.
Choice D reason: Cardiac arrhythmias are a significant concern in clients with hypokalemia. Potassium is crucial for proper cardiac function, and low levels can lead to abnormal heart rhythms. This is why monitoring for cardiac arrhythmias is essential in clients with hypokalemia.
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