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A nurse is teaching a client with diabetes mellitus who asks, 'Why is it necessary to maintain my blood glucose levels no lower than about 60 mg/dL?' How should the nurse respond?
- A. Glucose is the only fuel used by the body to produce the energy that it needs.
- B. Your brain needs a constant supply of glucose because it cannot store it.
- C. Without a minimum level of glucose, your body does not make red blood cells.
- D. Glucose in the blood prevents the formation of lactic acid and prevents acidosis.
Correct Answer: B
Rationale: Because the brain cannot synthesize or store significant amounts of glucose, a continuous supply from the body's circulation is needed to meet the fuel demands of the central nervous system. The nurse should educate the client to prevent hypoglycemia. The body can use other sources of fuel, including fat and protein, and glucose is not directly involved in the production of red blood cells. Glucose in the blood does not directly prevent lactic acid formation.
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A nurse teaches a client who is prescribed an insulin pump. Which statement should the nurse include in this client's discharge education?
- A. Test your urine daily for ketones.
- B. Use only buffered insulin in your pump.
- C. Store the insulin in the freezer until you need it.
- D. Change the needle every 3 days.
Correct Answer: D
Rationale: Changing the needle every 3 days reduces infection risk with insulin pumps. Testing urine for ketones, using buffered insulin, or freezing insulin are not recommended practices.
A preoperative nurse assesses a client who has type 1 diabetes mellitus prior to a surgical procedure. The client's blood glucose level is 160 mg/dL. Which action should the nurse take?
- A. Document the finding in the client's chart.
- B. Administer a bolus of regular insulin IV.
- C. Call the surgeon to cancel the procedure.
- D. Draw blood gases to assess the metabolic state.
Correct Answer: A
Rationale: A blood glucose of 160 mg/dL is within the acceptable range (140"?180 mg/dL) for perioperative management in type 1 diabetes, supporting better outcomes. The nurse should document the finding and proceed. Insulin, cancellation, or blood gases are not indicated.
After teaching a client who is recovering from pancreas transplantation, the nurse assesses the client's understanding. Which statement made by the client indicates a need for additional education?
- A. If I develop an infection, I should stop taking my corticosteroid.
- B. If I have pain over the transplant site, I will call the surgeon immediately.
- C. I should avoid people who are ill or who have an infection.
- D. I should take my cyclosporine exactly the way I was taught.
Correct Answer: A
Rationale: Stopping corticosteroids during an infection without consulting the transplant physician can endanger the graft. The other statements are correct, as pain may indicate rejection, avoiding infections is crucial, and adherence to cyclosporine is essential.
A nurse assesses a client with diabetes mellitus who self-administers subcutaneous insulin. The nurse notes a spongy, swelling area at the site the client uses most frequently for insulin injection. Which action should the nurse take?
- A. Apply ice to the site to reduce inflammation.
- B. Consult the provider for a new administration route.
- C. Assess the client for other signs of cellulitis.
- D. Instruct the client to rotate sites for insulin injection.
Correct Answer: D
Rationale: The spongy, swollen area suggests lipohypertrophy from repeated injections at the same site. Rotating injection sites prevents this complication. Ice, a new route, or assessing for cellulitis are not appropriate for lipohypertrophy.
After teaching a client who is newly diagnosed with type 2 diabetes mellitus, the nurse assesses the client's understanding. Which statement made by the client indicates a need for additional teaching?
- A. I should increase my intake of vegetables with higher amounts of dietary fiber.
- B. My intake of saturated fats should be no more than 10% of my total calories.
- C. I should decrease my intake of protein and eliminate carbohydrates from my diet.
- D. My intake of water is not restricted by my treatment plan or medication regimen.
Correct Answer: C
Rationale: Eliminating carbohydrates is incorrect; complex carbohydrates should be included in a diabetic diet. Protein reduction may be needed with microalbuminuria, but not elimination. The other statements are correct.