The practical nurse (PN) is caring for a client with a new prescription for fluticasone furoate nasal spray, a glucocorticoid prescribed for the client's nasal allergy symptoms. In reinforcing instructions about self-administration of the nasal spray, the PN should emphasize the need for the client to take which action before self-administration?

This is the correct answer because it allows the practical nurse (PN) to assess the parents' knowledge and understanding of hypospadias, and to provide accurate and relevant information based on their needs.
Hypospadias is a birth defect in boys in which the opening of the urethra is not located at the tip of the penis, but on the underside of the penis or in the scrotum²³. It is a common condition that affects about one in every 250 males at birth. Hypospadias does not resolve on its own and usually require surgical correction to prevent complications such as urinary tract infections, difficulty with urination and sexual function, and psychological distress¹². The PN should explain these facts to the parents and encourage them to discuss their concerns and questions with the health care provider. The PN should also provide emotional support and empathy to the parents, as they may feel anxious or guilty about their child's condition.

Based on the provided information, the following components should be included in the treatment regimen for this client:

• Oral anti-diabetic:

  While oral medications are common in managing type 2 diabetes, the current information does not suggest immediate initiation of pharmacotherapy based solely on the random blood sugar result without further evaluation.

• Weight-reduction treatment: With a BMI of 28, the client is considered overweight. Weight reduction is an important aspect of managing diabetes and improving overall health. The treatment regimen should include strategies to promote weight loss, such as dietary modifications and increased physical activity.
• Exercise planning: Regular exercise is beneficial for managing diabetes and promoting overall health. The treatment regimen should include an exercise plan tailored to the client's abilities and preferences. This may involve aerobic exercises, strength training, and flexibility exercises.
• Nutrition education: Nutrition plays a crucial role in diabetes management. The client should receive education on healthy eating habits, portion control, carbohydrate counting, and the importance of a balanced diet. The treatment regimen should include ongoing nutrition education and support.

The following options should not be included in the treatment regimen for this client:

• Short-acting insulin: Based on the information provided, there is no indication for the immediate use of short-acting insulin in this client.
• Long-acting insulin: Similar to short-acting insulin, there is no indication for the immediate use of long-acting insulin in this client.
• Extra carbohydrates: Extra carbohydrates may not be necessary for this client unless prescribed by a healthcare professional to manage hypoglycemia or specific dietary needs.