A nurse finds a client who has type 1 diabetes mellitus lying in bed, sweating, tachycardic, and reporting feeling lightheaded and shaky. Which of the following complications should the nurse suspect?
Hyperglycemia
Ketoacidosis
Nephropathy
Hypoglycemia
The Correct Answer is D
Rationale:
A. Hyperglycemia typically presents with polyuria, thirst, and blurred vision, rather than sweating and shakiness.
B. Diabetic ketoacidosis presents with symptoms like deep breathing (Kussmaul respirations), fruity breath, and confusion, not sweating and tachycardia.
C. Nephropathy does not cause these acute symptoms; it is a long-term complication involving kidney damage.
D. Hypoglycemia presents with symptoms such as sweating, tachycardia, shakiness, and lightheadedness, which match the client's presentation.
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Correct Answer is D
Explanation
Rationale:
A. Blood glucose levels should be checked every 3 to 4 hours during illness, not every 6 hours, due to the risk of hyperglycemia or diabetic ketoacidosis (DKA).
B. Juices, soda, and gelatin are allowed during illness as they provide quick carbohydrates, especially if the client is unable to eat solid foods.
C. The client may need to adjust insulin dosages based on blood glucose readings during illness, rather than simply administering the usual dose.
D. The nurse should instruct the client to report a blood glucose level greater than 300 mg/dL because this could indicate DKA or the need for more aggressive treatment.
Correct Answer is A
Explanation
Rationale:
A. Airway patency is the priority concern following a thyroidectomy due to the risk of swelling or bleeding that can compress the airway, leading to respiratory compromise.
B. Hoarseness can occur due to laryngeal nerve irritation but is not the priority over airway concerns.
C. Pain control is important but is not the primary priority compared to maintaining a patent airway.
D. Visual deficits are not typically related to postoperative thyroidectomy care.