A nurse is discussing the care of a client who has type 1 diabetes mellitus with an assistive personnel (AP). Which of the following situations should the nurse instruct the AP to report immediately?
The client asks the AP to trim his broken toenail.
The client reports urine that is dark yellow in color.
The client reports dizziness when standing.
The client refuses breakfast and requests to sleep.
The Correct Answer is D
Rationale:
A. Toenail trimming should be performed by a professional to prevent injury, but it does not require immediate reporting.
B. Dark yellow urine can indicate dehydration, but it is not an urgent concern in this context.
C. Dizziness when standing is a concern, but it does not take priority over the refusal of breakfast, which may lead to hypoglycemia.
D. A refusal to eat can lead to hypoglycemia in clients with type 1 diabetes, and this situation should be reported immediately to prevent a dangerous drop in blood glucose levels.
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Correct Answer is C
Explanation
Rationale:
A. Soaking feet is not recommended for clients with diabetes as it can cause skin maceration and increase the risk of infection.
B. Wearing sandals exposes the feet to injury and is not recommended for clients with diabetes. Closed-toed shoes are better for protecting the feet.
C. Daily foot inspection for sores, cuts, or bruises is essential for clients with diabetes to prevent infections and complications like diabetic ulcers.
D. Lotion should not be applied between the toes because it can promote excess moisture and fungal infections.
Correct Answer is D
Explanation
Rationale:
A. Hypertension does not contraindicate the use of sulfonylureas.
B. A blood glucose level of 140 mg/dL is a common finding in type 2 diabetes, and sulfonylureas are used to control such levels.
C. Shingles (herpes zoster) does not directly contraindicate the use of sulfonylureas.
D. Sulfonylureas should not be given to patients with a sulfa allergy because these medications contain sulfa compounds, which could cause an allergic reaction.