The nurse is providing discharge instructions to an older adult client who has diabetes mellitus and is taking oral hypoglycemic agents.

The nurse should advise the client to do which of the following?

Check blood glucose levels at least four times a day.

Drink plenty of fluids and avoid caffeine

Eat small, frequent meals and avoid simple sugars.

Report any signs of infection or delayed wound healing.

Answer and Explanation

The Correct Answer is D

The correct answer is D.

Report any signs of infection or delayed wound healing.

This is because oral hypoglycemic agents lower the blood glucose level, but they do not prevent the complications of diabetes mellitus, such as impaired wound healing and increased susceptibility to infections. Therefore, the client should be advised to monitor for any signs of infection, such as fever, redness, swelling, or pus, and report them to the health care provider promptly.

Choice A is wrong because checking blood glucose levels at least four times a day is not necessary for most clients who are taking oral hypoglycemic agents.

The frequency of blood glucose monitoring depends on the type and dose of medication, the level of glycemic control, and the presence of other factors that may affect blood glucose, such as illness or stress. The client should follow the individualized plan prescribed by the health care provider regarding blood glucose monitoring.

Choice B is wrong because drinking plenty of fluids and avoiding caffeine is not specific to clients who are taking oral hypoglycemic agents.

This is a general recommendation for all clients who have diabetes mellitus, as dehydration and caffeine can worsen hyperglycemia and increase the risk of diabetic ketoacidosis or hyperosmolar hyperglycemic state. However, this alone is not sufficient to manage diabetes mellitus and prevent complications.

Choice C is wrong because eating small, frequent meals and avoiding simple sugars is also a general recommendation for all clients who have diabetes mellitus, as this can help to maintain a stable blood glucose level and prevent hypoglycemia or hyperglycemia.

However, this alone is not sufficient to manage diabetes mellitus and prevent complications. The client should also follow a balanced diet that includes complex carbohydrates, protein, fiber, and healthy fats, and consult with a dietitian or a diabetes educator for individualized dietary guidance.

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Correct Answer is ["A","B","D"]

Explanation

The correct answer is A, B, and D.These are some of the strategies to prevent orthostatic hypotension, which is a sudden drop in blood pressure caused by a change in posture, such as when a person stands up quickly.

Some explanations for the other choices are:.

• Choice C is wrong because drinking caffeinated beverages can cause dehydration, which can worsen orthostatic hypotension by reducing the fluid volume in the blood vessels.

• Choice E is wrong because increasing salt intake can raise blood pressure, but it can also cause fluid retention, which can strain the heart and kidneys.People with hypertension, heart failure, or kidney disease should limit their salt intake.

Some normal ranges for blood pressure are:.

• Systolic blood pressure (the top number) should be less than 120 mmHg for most adults.

• Diastolic blood pressure (the bottom number) should be less than 80 mmHg for most adults.

• Orthostatic hypotension is diagnosed when there is a drop of 20 mmHg or more in systolic blood pressure or 10 mmHg or more in diastolic blood pressure within 2 to 5 minutes of standing.

A. Monitor the client’s skin for signs of injury or infection. B. Teach the client to avoid exposure to extreme temperatures. C. Encourage the client to use assistive devices for mobility and balance. D. Provide the client with sensory stimulation such as massage or music. E. Advise the client to wear loose-fitting clothing and shoes.

Correct Answer is ["A","B","C"]

Explanation

The correct answer isA, B, and C.

These interventions are appropriate for a client who has impaired tactile sensation due to aging.

• Ais correct because monitoring the client’s skin for signs of injury or infection can help prevent complications such as pressure ulcers, burns, or infections that might go unnoticed by the client due to reduced sensitivity.

• Bis correct because teaching the client to avoid exposure to extreme temperatures can protect the client from thermal injuries such as frostbite or heatstroke that might not be felt by the client due to diminished thermoreception.

• Cis correct because encouraging the client to use assistive devices for mobility and balance can enhance the client’s safety and independence by compensating for the loss of proprioception and kinesthesia that might impair the client’s coordination and stability.

• Dis wrong because providing the client with sensory stimulation such as massage or music is not directly related to impaired tactile sensation due to aging.While sensory stimulation might have other benefits for the client’s well-being, it does not address the specific problem of reduced touch perception.

• Eis wrong because advising the client to wear loose-fitting clothing and shoes is not helpful for a client who has impaired tactile sensation due to aging.In fact, loose-fitting clothing and shoes might increase the risk of falls or injuries by creating friction or slipping off the client’s body.

Normal ranges for tactile sensation vary depending on the type of stimulus, the location of the skin, and the method of testing.

However, some general guidelines are:.

• Vibration sense: normal threshold is less than 10 μm at 30 Hz on the fingertip.

• Temperature sense: normal threshold is less than 1°C difference between two stimuli on the forearm.

• Pressure sense: normal threshold is less than 10 g/mm2 on the fingertip.

• Pain sense: normal threshold is less than 0.5 g/mm2 on the fingertip.

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The nurse is providing discharge instructions to an older adult client who has diabetes mellitus and is taking oral hypoglycemic agents. The nurse should advise the client to do which of the following?

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Naxlex Comprehensive Predictor Exams

A nurse is educating a client who is 60 years old about strategies to prevent orthostatic hypotension. Which of the following instructions should the nurse include? (Select all that apply.).

Correct Answer is ["A","B","D"]

Explanation

A nurse is planning care for an older adult client who has impaired tactile sensation due to aging. Which of the following interventions should the nurse include? (Select all that apply.).

Correct Answer is ["A","B","C"]

Explanation

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The nurse is providing discharge instructions to an older adult client who has diabetes mellitus and is taking oral hypoglycemic agents.

The nurse should advise the client to do which of the following?