A client with diabetes and heart failure can expect better outcomes from heart failure in which of the following situations?
1. Hemoglobin A1C is 5.8%.
2. Fingerstick blood sugar is 155.
3. Hemoglobin is 14 g/dl.
4. Creatinine is 2.2 mg/dl.
Hemoglobin A1C is 5.8%.
Rationale: The client who maintains strict glycemic control as evidenced by the hemoglobin A1C being < 6% will have better heart failure outcomes. A fingerstick blood sugar of 155 is not glycemic control and is a one-time result, whereas the hemoglobin A1C is an average of the blood sugar over a 3-month time frame. The hemoglobin plays no role in long-term mortality of heart failure. A creatinine of 2.2 mg/dl is high and could indicate renal involvement.
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