A nurse teaches a client who is diagnosed with diabetes mellitus. Which statement should the nurse include in this client's plan of care to delay the onset of microvascular and macrovascular complications?
- A. Maintain tight glycemic control and prevent hyperglycemia.
- B. Prevent hypoglycemia with insulin.
- C. Restrict your fluid intake to no more than 2 liters a day.
- D. Limit your intake of protein to prevent ketoacidosis.
Correct Answer: A
Rationale: Hyperglycemia is a critical factor in the pathogenesis of long-term diabetic complications. Maintaining tight glycemic control helps delay the onset of microvascular and macrovascular complications. Fluid restriction, preventing hypoglycemia, and limiting protein are not the primary strategies for this goal.
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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.
After teaching a client 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 need to have an annual appointment even if my glucose levels are in good control.
- B. Since my diabetes is controlled with diet and exercise, I must be seen only if I am sick.
- C. I can still develop complications even though I do not have to take insulin at this time.
- D. If I have surgery or get very ill, I may have to receive insulin injections for a short time.
Correct Answer: B
Rationale: Clients with type 2 diabetes need annual checkups to monitor for complications, regardless of control method. The other statements are accurate regarding complication risks and potential insulin needs.
A nurse cares for a client who has diabetes mellitus. The nurse administers 6 units of regular insulin and 10 units of NPH insulin at 0700. At which time should the nurse assess the client for potential problems related to the NPH insulin?
- A. 800
- B. 1600
- C. 2000
- D. 2300
Correct Answer: B
Rationale: NPH insulin peaks 4"?12 hours after administration (0700), so 1600 is within the peak time for potential hypoglycemia. 0800 is too early, and 2000/2300 are too late.
A nurse reviews the laboratory results of a client who is receiving intravenous insulin. Which should alert the nurse to intervene immediately?
- A. Serum chloride level of 98 mmol/L.
- B. Serum calcium level of 8.8 mg/dL.
- C. Serum sodium level of 132 mmol/L.
- D. Serum potassium level of 2.5 mmol/L.
Correct Answer: D
Rationale: Insulin promotes potassium movement into cells, risking hypokalemia (2.5 mmol/L is low). This requires immediate intervention to prevent complications like arrhythmias. The other values are near normal and not directly related to insulin therapy.
A nurse cares for a client who has a family history of diabetes mellitus. The client states, 'My father has type 1 diabetes mellitus. Will I develop this disease as well?' How should the nurse respond?
- A. Your risk of diabetes is higher than the general population, but it may not occur.
- B. No genetic risk is associated with the development of type 1 diabetes mellitus.
- C. The risk for becoming diabetic is 50% because of how it is inherited.
- D. Female children do not inherit diabetes mellitus, but male children will.
Correct Answer: A
Rationale: Risk for type 1 diabetes is influenced by inheritance of genes coding for HLA-DR and HLA-DQ tissue types. Having a parent with type 1 diabetes increases the risk, but environmental factors also play a role, so not everyone with these genes develops diabetes. The other statements are inaccurate.
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