The nurse is continuing to care for the client.

Exhibits

Which of the following conditions is the client is at greatest risk for developing? Select all that apply

Rationale:
A. Acetone breath odor: A fruity or acetone breath odor occurs when the body produces ketones due to fat breakdown in hyperglycemia or diabetic ketoacidosis (DKA). This finding is not associated with hypoglycemia but rather prolonged high blood glucose levels.

B. Polydipsia: Excessive thirst (polydipsia) is a sign of hyperglycemia because the kidneys attempt to excrete excess glucose, leading to dehydration. It does not occur during hypoglycemia, when blood sugar levels are abnormally low.

C. Inability to concentrate: Low blood glucose deprives the brain of its primary energy source, leading to confusion, irritability, and difficulty concentrating. These neuroglycopenic symptoms are hallmark signs of hypoglycemia and can progress to altered consciousness if untreated.

D. Diaphoresis: Sweating is a classic adrenergic response to hypoglycemia as the body releases epinephrine to raise blood glucose levels. It serves as an early warning sign, prompting immediate carbohydrate intake to prevent further decline in blood sugar.

E. Tremors: Tremors occur due to increased sympathetic nervous system activity during hypoglycemia. The body responds to falling glucose by releasing catecholamines, which stimulate muscle activity and cause shaking or trembling sensations.

Rationale:
A. A health care surrogate makes health care decisions when the client is no longer able: A health care surrogate, also called a health care proxy, is designated by the client to make medical decisions on their behalf if they become incapacitated.

B. Advance directives cannot be changed once implemented: Advance directives are legally binding but can be revised or revoked by the client at any time while they are competent. Flexibility allows clients to update their preferences as their health status or values change.

C. Assigning a health care surrogate requires legal consultation: While consulting an attorney can be helpful, it is not required to designate a health care surrogate. Most states allow clients to assign a surrogate using standardized forms provided by healthcare facilities or state agencies.

D. A client must create a do-not-resuscitate order when completing advance directives: Creating a DNR order is optional and only applicable if the client wishes to limit resuscitation. Advance directives encompass broader healthcare decisions beyond resuscitation preferences.