Fred, a newly diagnosed diabetic, is being discharged tomorrow. Which of the following should he be taught to report to his physician?

Correct Answer: D

Rationale: In this scenario, the correct answer is D) An ear infection following swimming. This is the correct choice because individuals with diabetes are more prone to infections due to their compromised immune system. An ear infection following swimming can be a sign of a more serious issue, such as a fungal infection, which can worsen quickly in a diabetic patient. Option A) A weight loss of 2 lb may not be alarming in a general context, but for a newly diagnosed diabetic, unexpected weight loss can be a symptom of uncontrolled blood sugar levels or other underlying health issues that need immediate medical attention. Option B) Having an occasional alcoholic drink can be a concern for diabetic patients due to its impact on blood sugar levels, but it is not as urgent as reporting a potential infection. Option C) Planning to play in a tennis tournament is not an immediate concern unless it involves significant physical exertion that could affect blood sugar levels, which can be managed with appropriate adjustments to insulin or medication. Educationally, it is crucial for diabetic patients to understand the importance of promptly reporting any signs of infection or unusual symptoms to their physician to prevent complications and ensure timely treatment. Teaching patients to recognize and act on such warning signs is essential for their overall health management and well-being.

Correct Answer: D

Rationale: The correct answer is D) Consulting a family member or the caregiver to confirm the drugs the client is taking. This is essential because older adults may have complex medication regimens, including over-the-counter medications and herbal supplements, which can have interactions or adverse effects during a diagnostic examination. By verifying the client's current medications with a family member or caregiver, the nurse can ensure accurate information and provide safe care. Option A) Consulting the physician is not the most appropriate choice in this scenario as the physician may not have immediate access to the client's complete medication history. It is more efficient to consult someone who is directly involved in the client's daily care. Option B) Consulting a family member or caregiver to confirm the client's diet history is not relevant to obtaining a drug history, which is the primary concern in this situation. Option C) Consulting the institution's procedure manual is not the best approach for obtaining an individual client's drug history, as this information is specific to the client and may not be documented in the manual. Relying on a manual could lead to inaccuracies in the medication information provided. In an educational context, this question highlights the importance of thorough medication reconciliation in older adults, emphasizing the need for healthcare providers to gather accurate and comprehensive information about a patient's medication regimen to ensure safe and effective care. It also underscores the significance of involving family members or caregivers in the care process to enhance communication and collaboration in managing the client's health.

Correct Answer: A

Rationale: Rationale: The correct answer is A) Eat a diet high in protein, low in refined carbohydrates. This is because individuals with Addison's disease have decreased cortisol production, which can lead to problems with blood sugar regulation. Eating a diet high in protein and low in refined carbohydrates can help stabilize blood sugar levels and prevent spikes and crashes. Protein is also crucial for muscle maintenance and repair, which can be important for individuals with Addison's disease who may experience muscle weakness. Option B) Consume two meals per day is incorrect because individuals with Addison's disease actually benefit from consuming multiple small meals throughout the day to help maintain stable blood sugar levels. Option C) Eat foods high in potassium is incorrect because individuals with Addison's disease are at risk of hyperkalemia (high potassium levels), so they should actually avoid foods high in potassium. Option D) Drink less than 1 L of fluid per day is incorrect because individuals with Addison's disease are often at risk of dehydration due to low aldosterone levels, so adequate fluid intake is important to prevent dehydration and maintain electrolyte balance. In an educational context, it is important for healthcare providers and nurses to understand the specific nutritional needs of individuals with Addison's disease to provide appropriate care and education. By understanding the rationale behind the correct nutrition instructions, healthcare professionals can help patients manage their condition effectively and improve their overall health outcomes.

Correct Answer: A

Rationale: In this scenario, the most appropriate patient for the LPN to care for is the 51-year-old patient with bilateral adrenalectomy who just returned from the post-anesthesia care unit (Option A). This choice is based on the specific needs of this patient following a surgical procedure that involves the removal of both adrenal glands. The patient would require close monitoring of vital signs, assessment for signs of adrenal insufficiency or adrenal crisis, wound care, pain management, and early detection of complications such as hemorrhage or infection. Option B, the 83-year-old patient with type 2 diabetes and chronic obstructive pulmonary disease, requires complex care management due to multiple chronic conditions, which may necessitate a higher level of nursing skill and critical thinking beyond the scope of an LPN. Option C, the 38-year-old patient with myocardial infarction preparing for discharge, may still require close monitoring and education on post-discharge care, which is often managed by a more experienced nurse. Option D, the 72-year-old patient with mental status changes admitted from long-term care, may need assessment and interventions related to altered mental status, which could involve complex care and coordination with other healthcare professionals. Assigning the patient with bilateral adrenalectomy to the LPN provides a learning opportunity for the LPN to develop skills in postoperative care, endocrine system management, and surgical recovery while ensuring the patient receives appropriate care under the supervision of the RN team leader. This decision aligns with the principles of effective delegation and patient safety, as it matches the patient's needs with the appropriate level of nursing expertise.

Correct Answer: B

Rationale: In this scenario, the correct answer is B) 15 grams of carbohydrates. When a diabetic client is experiencing hypoglycemia with a blood glucose level of 54, it is important to provide a rapid source of glucose to raise their blood sugar to a safe level. The recommended amount of fast-acting carbohydrates to treat hypoglycemia is around 15 grams. Option A) 20 grams is excessive and may lead to hyperglycemia, which can be harmful to the client. Option C) 10 grams may not be sufficient to raise the blood sugar quickly to a safe level. Option D) 5 grams is too low and may not effectively treat the hypoglycemia. Educationally, it is crucial for healthcare professionals, especially nurses, to understand the appropriate management of hypoglycemia in diabetic clients. Providing the correct amount of carbohydrates promptly can prevent serious complications such as seizures, loss of consciousness, or even death. This knowledge is essential in ensuring the safety and well-being of diabetic patients in various healthcare settings.