The nurse is planning care for a client with diabetes who is prescribed lifelong therapy for adrenal insufficiency. Which advice should not be given to this client?
1. "Cut your toenails straight across."
2. "Avoid wearing socks with shoes."
3. "Keep a diary of your blood glucose measurements."
4. "Call your health care provider if you are injured or get sick."
Correct Answer: 2
Rationale 1: Cutting the toenails straight across is appropriate for the client with diabetes.
Rationale 2: A client with diabetes might have peripheral neuropathy. The addition of corticosteroids can prolong wound healing if a wound develops from friction of the shoe against bare skin.
Rationale 3: A client with diabetes starting therapy with corticosteroids might have marked changes in blood glucose values, and a diary of this information should be maintained.
Rationale 4: The client should call the health care provider to report illness or injury. An increased dose of corticosteroid could be indicated.
Global Rationale: A client with diabetes might have peripheral neuropathy. The addition of corticosteroids can prolong wound healing if a wound develops from friction of the shoe against bare skin. Cutting the toenails straight across is appropriate for the client with diabetes. A client with diabetes starting therapy with corticosteroids might have marked changes in blood glucose values, and a diary of this information should be maintained. The client should call the health care provider to report illness or injury. An increased dose of corticosteroid could be indicated.
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