Which of the following patients is at the highest risk for hyperosmolar hyperglycemic syndrome?
a. An 18-year-old college student with type 1 diabetes who exercises excessively
b. A 45-year-old woman with type 1 diabetes who forgets to take her insulin in the morning
c. A 75-year-old man with type 2 diabetes and coronary artery disease who has recently started on insulin injections
d. An 83-year-old, long-term care resident with type 2 diabetes and advanced Alzheimer's disease who recently developed influenza
D
Hyperosmolar hyperglycemic syndrome is more common in type 2 diabetes; influenza is a stressor that would result in further increases in blood sugar. Some individuals with advanced Alzheimer's disease cannot communicate thirst needs and may be incontinent, making hypertonic fluid loss more difficult to estimate. Uncontrolled type 1 diabetes is associated with diabetic ketoacidosis. Interruption of insulin delivery related to a missed insulin dose in type 1 diabetes creates a situation of absolute insulin deficiency in type 1 diabetes and is associated with diabetic ketoacidosis. A patient with type 2 diabetes who is new to insulin is at risk for hypoglycemia.
You might also like to view...
A nursing diagnosis for a patient with bulimia nervosa is Ineffective coping related to feelings of loneliness and isolation, as evidenced by use of overeating and self-induced vomiting to comfort self
Select the best outcome related to this diagnosis. Within 2 weeks, the patient will: a. appropriately express angry feelings. b. verbalize two positive things about self. c. verbalize the importance of eating a balanced diet. d. identify two alternative methods of coping with loneliness and isolation.
A nurse can deal preventively with the potential for experiencing negative feelings while working
with a severely depressed client by (more than one response may be correct) A. understanding the part neurotransmitters play in depression. B. establishing realistic expectations for the client and self. C. focusing as little as possible on feelings toward the client. D. disregarding empathic information originating in the client.
An adolescent patient comes to the clinic complaining of a burning sensation upon urination and a puslike discharge from the penis. The nurse is correct to suspect that the patient has
a. syphilis. b. nongonococcal urethritis. c. herpes simplex. d. gonorrhea.
A 73-year-old client shares with the nurse that she feels so useless, especially now that arthritis makes her life-long hobby of hand sewing so painful as to make it almost impossible
Which of the following nursing responses is most therapeutic given the client's current poor self-esteem image? 1. "What is it about sewing that makes it so enjoyable for you?" 2. "I'm sure your sewing is beautiful; have you ever considered teaching others to sew?" 3. "Maybe you can find something else that will give you as much satisfaction about yourself." 4. "We can attempt to find the proper pain management plan to minimize the dis-comfort so you can sew again."