Nokea
After teaching a client with diabetes mellitus to inject insulin, the nurse assesses the client's understanding. Which statement made by the client indicates a need for additional teaching?
- A. The lower abdomen is the best location because it is closest to the pancreas.
- B. I can reach my thigh the best, so I will use the different areas of my thighs.
- C. By rotating the sites in one area, my chance of having a reaction is decreased.
- D. Changing injection sites from the thigh to the arm will change absorption rates.
Correct Answer: A
Rationale: The abdominal site has the fastest insulin absorption due to its blood supply, not proximity to the pancreas. The other statements are accurate regarding site rotation and absorption rates.
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A nurse develops a dietary plan for a client with diabetes mellitus and new-onset microalbuminuria. Which component of the client's diet should the nurse decrease?
- A. Carbohydrates
- B. Proteins
- C. Fats
- D. Total calories
Correct Answer: B
Rationale: Restricting dietary protein to 0.8 g/kg/day is recommended for clients with microalbuminuria to slow progression to renal failure. Carbohydrates, fats, or total calories do not need specific reduction in this context.
A nurse assesses a client with diabetes mellitus 3 hours after a surgical procedure and notes the client's breath has a fruity odor. Which action should the nurse take?
- A. Encourage the client to use an incentive spirometer.
- B. Increase the client's intravenous fluid flow rate.
- C. Consult the provider to test for ketoacidosis.
- D. Perform meticulous pulmonary hygiene care.
Correct Answer: C
Rationale: A fruity breath odor is a sign of ketoacidosis, common post-surgery due to stress-induced insulin suppression. Consulting the provider to test for ketoacidosis is the priority. Spirometry, increasing fluids, or pulmonary hygiene do not address this issue.
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.
A nurse cares for a client with diabetes mellitus who asks, 'Why do I need to administer more than one injection of insulin each day?' How should the nurse respond?
- A. You need to start with multiple injections until you become more proficient at self-injection.
- B. A single dose of insulin each day would not match your blood insulin levels and your food intake patterns.
- C. A regimen of a single dose of insulin injected each day would require that you eat fewer carbohydrates.
- D. A single dose of insulin would be too large to be absorbed, putting you at risk for insulin shock.
Correct Answer: B
Rationale: Multiple insulin injections are needed to match insulin levels with food intake and activity patterns, preventing wide blood glucose fluctuations. Proficiency in injection, carbohydrate restriction, or absorption issues are not the primary reasons for multiple doses.
When teaching a client recently diagnosed with type 1 diabetes mellitus, the client states, 'I will never be able to stick myself with a needle.' How should the nurse respond?
- A. I can give your injections to you while you are here in the hospital.
- B. Everyone gets used to giving themselves injections. It really does not hurt.
- C. Your disease will not be managed properly if you refuse to administer the shots.
- D. Tell me what it is about the injections that are concerning you.
Correct Answer: D
Rationale: Exploring the client's concerns about injections promotes understanding and tailored education, supporting self-care. Offering to give injections, minimizing concerns, or warning about poor management are less effective.