You have just returned from a 2-day workshop on guidelines for the care of surgical patients with type
1 dM. you notice that e.B.'s daily fasting blood glucose has been running between 130 and 180 mg/dL.
The sliding scale insulin intervention does not begin until blood glucose values equal to or greater than
200 mg/dL are reported. you recognize that patients with blood glucose values even slightly above normal levels experience impaired wound healing. However, you also recognize that the risks related to
hypoglycemia, such as falls, might outweigh the risk of impaired healing from elevated glucose levels.
Identify four interventions that would facilitate timely healing of E.B.'s residual limb.
What will be an ideal response?
• Suggest that the surgeon order a certified diabetes educator consultation to help regulate E.B.'s
blood glucose.
• Request more frequent glucose monitoring, such as before meals and at bedtime.
• Increase baseline insulin (prospective action), rather than using higher sliding scale insulin levels
(retrospective action).
• Enlist the family's cooperation in not bringing in outside food; however, if the patient is not eating,
this might be necessary. Ask them to inform the nursing staff of supplemental food and ensure
that there is adequate insulin coverage.
• Request a physical therapist (PT) consultation for activity to simulate more normal daily caloric
expenditure.
You might also like to view...
A 28-year-old married attorney with one child is in the first trimester of her second pregnancy. A colleague states that she is at no risk for HIV, so she would not need to be counseled about testing for HIV
The nurse's most appropriate response would be a. "She's a professional woman in a monogamous relationship. She obviously is not at risk." b. "Women are not at great risk. The greatest risk is with gay men." c. "The fastest-growing segment of the population with AIDS is women and children. We need to assess her risks." d. "We need to review her chart to determine if her first child was infected."
The healthcare team is caring for a client with early atherosclerotic changes within the blood vessels. The physician orders diagnostic testing, and the nurse provides cardiovascular teaching
Which primary goal is the healthcare team working toward? A) Preserving the natural heart by avoiding further heart disease B) Preventing age-related changes which could jeopardize health C) Monitoring cardiovascular status and current health needs D) Increasing client knowledge base for independent care
A shortcoming that needs to be addressed related to the advertising of open nursing positions is:
a. inadequate use of Internet advertising. b. insufficient funds allotted for advertising. c. lack of follow-up with potential candi-dates. d. short supply of advertising space in nurs-ing journals.
The nurse talks with every assigned client to ensure satisfaction with the care received. Which of the following could be a cause for client dissatisfaction?
a. Frequent communication with health care providers regarding treatment plan b. Delayed pain medication c. Meal trays delivered on time with correct items d. Ability to read each health provider's name tag clearly