1. You are preparing to review a teaching plan for a patient with type 2 diabetes
mellitus. To determine the patient's level of compliance with his
... [Show More] prescribed diabetic
regimen, which value would you be sure to review?
1. Fasting glucose level
2. Oral glucose tolerance test results
3. Glycosylated hemoglobin (HgbA1c) level
4. Fingerstick glucose findings for 24 hours - Ans: 3 Glycosylated hemoglobin (HgbA1c)
level
The higher the blood glucose level is over time, the more glycosylated the hemoglobin
becomes. The HgbA1c level is a good indicator of the average blood glucose level over
the previous 120 days. Fasting glucose and oral glucose tolerance tests are important
diagnostic tools. Fingerstick blood glucose monitoring provides information that allows
adjustment of the patient's therapeutic regimen. Focus: Prioritization
2. A patient has newly-diagnosed type 2 diabetes. Which task should you delegate to a
UAP?
1. Arranging a consult with the dietitian
2. Assessing the patient's insulin injection technique
3. Teaching the patient to use a glucometer to monitor glucose at home
4. Reminding the patient to check glucose level before each meal - Ans: 4 Reminding
the patient to check glucose level before each meal
The UAP's role includes reminding patients about interventions that are already part of
the plan of care. Arranging for a consult with the dietitian is appropriate for the unit clerk.
Teaching and assessing require additional education and should be carried out by
licensed nurses. Focus: Delegation, supervision, assignment
3. A nursing diagnosis for a patient with newly-diagnosed diabetes is Risk for Injury
related to sensory alterations. Which key points should you include in the teaching plan
for this patient? (Select all that apply.)
1. "Clean and inspect your feet every day."
2. "Be sure that your shoes fit properly."
3. "Nylon socks are best to prevent friction on your toes from shoes."
4. "Only a podiatrist should trim your toenails."
5. "Report any nonhealing skin breaks to your health care provider." - Ans: 1, 2, 5
1. "Clean and inspect your feet every day."
2. "Be sure that your shoes fit properly."
5. "Report any nonhealing skin breaks to your health care provider."
Sensory alterations are the major cause of foot complications in diabetic patients, and
patients should be taught to examine their feet on a daily basis. Properly-fitted shoes
protect the patient from foot complications. Broken skin increases the risk of infection.
Cotton socks are recommended to absorb moisture. Patients, family, or health care
providers may trim toenails. Focus: Prioritization
4. An LPN/LVN's assessment of two diabetic patients reveals all of these findings.
Which would you instruct the LPN/LVN to report immediately?
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