The nurse teaches a diabetic client about Sick Day Rules. Which patient statement or statements indicate understanding of the Sick Day Rules? (SELECT ALL THAT APPLY)

I will report nausea, vomiting, or diarrhea to my primary care provider.

I should avoid carbohydrates when I'm sick.

I should stop taking my insulin or oral antidiabetic agents.

I will test my blood glucose and test urine ketones every 3 to 4 hours.

I will continue taking my insulin or oral antidiabetic agents as usual.

Answer and Explanation

Correct Answer : A,D,E

A. I will report nausea, vomiting, or diarrhea to my primary care provider.
Correct Understanding: This is correct. Reporting these symptoms is essential because illness, especially with symptoms like nausea, vomiting, or diarrhea, can impact blood glucose levels.

B. I should avoid carbohydrates when I'm sick.
Need for Further Teaching: During illness, it's important to continue consuming carbohydrates. However, the type and amount of carbohydrates might need to be adjusted. Patients should consult their healthcare providers for guidance on managing carbohydrate intake during illness.

C. I should stop taking my insulin or oral antidiabetic agents.
Need for Further Teaching: It is not advisable to stop insulin or oral antidiabetic agents during illness. In fact, these medications often need to be continued, with potential adjustments made under the guidance of healthcare providers.

D. I will test my blood glucose and test urine ketones every 3 to 4 hours.
Correct Understanding: This is correct. Regular monitoring of blood glucose and urine ketones during illness is crucial for managing diabetes and detecting any potential complications.

E. I will continue taking my insulin or oral antidiabetic agents as usual.
Correct Understanding: This is correct. It's important to continue taking insulin or oral antidiabetic agents during illness to help manage blood glucose levels.

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Correct Answer is B

Explanation

A. Leukemia:
Explanation: Leukemia is a cancer of the blood-forming tissues, including the bone marrow and lymphatic system. It typically presents with an abnormal increase in white blood cells. While fatigue can be a symptom, increased bilirubin concentration and an increased reticulocyte count are not typical findings in leukemia.

B. Hemolytic Anemia:
Explanation: Hemolytic anemia is characterized by the premature destruction of red blood cells, leading to an increased release of bilirubin (from the breakdown of hemoglobin) and an increased reticulocyte count (as the body attempts to compensate by producing more red blood cells). This is a likely possibility given the presented symptoms.

C. Hypoproliferative Anemia:
Explanation: Hypoproliferative anemia is characterized by a decreased production of red blood cells. It is unlikely in this scenario, as an increased reticulocyte count suggests an attempt by the bone marrow to increase red blood cell production.

D. Thrombocytopenia:
Explanation: Thrombocytopenia is a condition characterized by a low platelet count. It does not typically present with an increased bilirubin concentration or an increased reticulocyte count.

A. "The parathyroid has no effect on calcium levels in the body, this will just help prevent osteoporosis" B. "The reason you have hypo-parathyroidism is because you were diagnosed with hypothyroidism, and when the thyroid doesn't work, neither does the parathyroid, so you need these supplements." C. "A decrease in parathyroid hormone causes low calcium levels, so your body to break down bones in order to maintain normal calcium levels, and this will prevent that from happening." D. "An increase in parathyroid hormone causes your body to move calcium into the cells to reduce blood calcium levels, so you have to replace the levels in the blood."

Correct Answer is C

Explanation

A. "The parathyroid has no effect on calcium levels in the body; this will just help prevent osteoporosis":
Explanation: This statement is incorrect. The parathyroid gland plays a crucial role in calcium homeostasis. Hypoparathyroidism, characterized by decreased parathyroid hormone (PTH) production, leads to low blood calcium levels, not high levels.

B. "The reason you have hypoparathyroidism is that you were diagnosed with hypothyroidism, and when the thyroid doesn't work, neither does the parathyroid, so you need these supplements."
Explanation: This statement is incorrect. The parathyroid and thyroid are separate glands with distinct functions. Hypoparathyroidism is not a result of hypothyroidism.

C. "A decrease in parathyroid hormone causes low calcium levels, so your body to break down bones to maintain normal calcium levels, and this will prevent that from happening."
Explanation: This is the correct statement. Hypoparathyroidism leads to a decrease in PTH, resulting in low blood calcium levels. Without sufficient PTH, the body may resort to breaking down bones to maintain calcium levels.

D. "An increase in parathyroid hormone causes your body to move calcium into the cells to reduce blood calcium levels, so you have to replace the levels in the blood."
Explanation: This statement is incorrect. An increase in parathyroid hormone (PTH) typically leads to increased blood calcium levels by promoting the release of calcium from bones and reducing calcium excretion by the kidneys. This describes hyperparathyroidism, not hypoparathyroidism.

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The nurse teaches a diabetic client about Sick Day Rules. Which patient statement or statements indicate understanding of the Sick Day Rules? (SELECT ALL THAT APPLY)

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client comes into the clinic complaining of fatigue. Blood work shows an increased bilirubin concentration and an increased reticulocyte count. What would the nurse suspect the patient has?

Correct Answer is B

Explanation

A nurse is instructing a client with newly diagnosed hypo-parathyroidism about this disorder. The nurse explains to the patient that the physician has prescribed daily supplements of calcium and vitamin D. Which education by the nurse is appropriate for this patient?

Correct Answer is C

Explanation

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