A patient with type 1 diabetes has had elevated blood sugar readings for several mornings in a row and it is suspected the patient is experiencing the Somogyi effect
Which of the following changes in medication or diet does the nurse anticipate will be needed for this patient? 1. addition of a protein bedtime snack
2. an increase in the morning dose of insulin
3. an increase in regular insulin sliding scale coverage
4. addition of protein at the breakfast meal
1
Rationale: The Somogyi effect is triggered by nocturnal hypoglycemia, which in turn causes release of stress hormones, resulting in early morning hyperglycemia. Adding protein to the bedtime snack may prevent the nocturnal hypoglycemia. Increasing the morning dose of insulin would further aggravate the situation; less insulin is often needed. Increasing protein at breakfast also would not affect the early morning hyperglycemia.
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A nurse is providing education for a patient recently started on levothyroxine (Levothroid)
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Which of the following best describes most Americans' attitude toward immigrants?
a. Ambivalence because there are no clear solutions about how to address their needs b. Strongly negative because immigrants take jobs that native-born Americans could have instead c. Strongly positive because immigrants bring useful job skills and often join previous family members already in the United States d. Strong opposition to further immigration because of the increasing population in the United States