The nurse is monitoring a client who was diagnosed with Type 1 Diabetes Mellitus and is being treated with NPH and regular insulin. Which manifestations alert the nurse to the presence of a possible hypoglycemic reaction? (SELECT ALL THAT APPLY)

A. "The test needs to be repeated following a 12-hour fast."
This statement is not accurate. The hemoglobin A1c test does not require fasting. It reflects the average blood glucose levels over the past two to three months and is not affected by short-term changes in diet or fasting.

B. "It tells us about your sugar control for the last 3 months."
This statement is accurate. The hemoglobin A1c test provides information about the average blood glucose levels over the past two to three months. It's a valuable tool for assessing long-term glycemic control.

C. "It looks like you aren't following the prescribed diabetic diet."
The hemoglobin A1c test reflects overall glycemic control over several months and is not solely influenced by recent dietary habits. While diet plays a role in diabetes management, this statement oversimplifies the interpretation of the A1c result.

D. "Your insulin regimen needs to be altered significantly."
While a high A1c may indicate a need for adjustments in the treatment plan, the decision to alter the insulin regimen should be based on a comprehensive assessment of the patient's overall diabetes management, including lifestyle, diet, and other factors. It may not solely be determined by the A1c result.

A. Management of diabetic ketoacidosis:
Diabetic ketoacidosis (DKA) is a severe complication of diabetes characterized by high blood sugar, ketones in the urine, and metabolic acidosis. While it's crucial to understand how to manage DKA, this may be considered more advanced knowledge and may not be categorized as a basic survival skill for someone newly diagnosed with type 1 diabetes.

B. Signs and symptoms of diabetic neuropathy:
Diabetic neuropathy is a long-term complication that involves damage to the nerves due to prolonged high blood sugar levels. While understanding neuropathy is important for long-term health, it may not be the first topic addressed as a basic survival skill for someone newly diagnosed.

C. Effects of surgery and pregnancy on blood sugar levels:
Understanding how surgery and pregnancy can affect blood sugar levels is important for managing diabetes in specific situations. However, this knowledge might be considered more advanced and may not be the initial focus for someone just starting to learn about diabetes self-care.

D. Recognition of hypoglycemia and hyperglycemia:
Recognizing the signs and symptoms of both low and high blood sugar is essential for immediate self-care. This includes understanding when blood sugar is too low (hypoglycemia) and requires prompt treatment, as well as recognizing the symptoms of high blood sugar (hyperglycemia) and knowing how to address them. This knowledge is fundamental for the daily management and well-being of someone with diabetes.