The nurse is assessing a 55-yr-old female patient with type 2 diabetes who has a body mass index (BMI) of 31 kg/m2.Which goal in the plan of care is most important for this patient?
The patient will choose a diet that distributes calories throughout the day.
The patient will reach a glycosylated hemoglobin level of less than 7%.
The patient will follow a diet and exercise plan that results in weight loss.
The patient will state the reasons for eliminating simple sugars in the diet.
The Correct Answer is B
Glycosylated hemoglobin (HbA1c) is a measure of the average blood glucose levels over the past 2-3 months. An HbA1c level of less than 7% is associated with a reduced risk of microvascular and macrovascular complications in patients with diabetes. This is a critical goal because uncontrolled blood glucose levels can lead to complications such as neuropathy, nephropathy, retinopathy, and cardiovascular disease.
While options a, c, and d are also important in the management of diabetes, they are not as critical as achieving glycemic control. Choosing a diet that distributes calories throughout the day can help regulate blood glucose levels and prevent hypoglycemia. Following a diet and exercise plan that results in weight loss can also help improve glycemic control and reduce the risk of complications. Understanding the reasons for eliminating simple sugars in the diet is important for overall diabetes education, but it is not the most important goal in the plan of care for this patient at this time.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Since the patient's pre meal blood sugar is 311 mg/dL, according to the sliding scale, the patient requires 8 units of Humalog insulin. Therefore, the nurse should administer 8 units of Humalog insulin before the patient's meal. It is important to note that if the patient's blood glucose level is greater than 400 mg/dL, the nurse should call the MD instead of administering insulin. Keeping the patient NPO (nothing by mouth) is not necessary in this situation, as the patient is awake, alert, and able to swallow, and will require their meal for adequate nutrition. However, it is important to monitor the patient's blood glucose level after administering insulin and adjust the dosage if necessary.
Correct Answer is B
Explanation
The patient received 38 U of NPH insulin at 7:00 AM, and by 1:00 PM, the insulin has been active for approximately 6 hours. The patient has missed lunch, which may lead to hypoglycemia, especially with the activity of the insulin.
Sending a glass of orange juice will provide the patient with a quick source of glucose to prevent hypoglycemia. If testing is further delayed, the nurse may request that the patient be allowed to eat lunch first or save the lunch tray for later, but immediate intervention is necessary to prevent hypoglycemia. Discontinuing the evening dose of insulin is not an appropriate action and should not be considered without consulting the healthcare provider.
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