What should the goals of nutrition therapy for the patient with type 2 diabetes include?

Correct Answer: B

Rationale: In managing type 2 diabetes, nutrition therapy plays a crucial role in achieving optimal health outcomes. The correct answer, option B) Normal serum glucose and lipid levels, is the most appropriate goal for nutrition therapy in a patient with type 2 diabetes. Maintaining normal glucose levels helps in managing blood sugar levels effectively, which is essential to prevent complications associated with diabetes. Additionally, managing lipid levels is crucial as diabetes increases the risk of cardiovascular diseases, and controlling lipids helps reduce this risk. Option A) Ideal body weight is important for overall health, but it may not be the primary goal of nutrition therapy for a patient with type 2 diabetes. While weight management is important, controlling glucose and lipid levels are more directly related to managing the condition and reducing associated risks. Option C) A special diabetic diet using dietetic foods is not necessarily the goal of nutrition therapy for type 2 diabetes. While dietary modifications are important, emphasizing a "special" diet may not be sustainable or evidence-based. Instead, a well-balanced, individualized approach focusing on overall dietary patterns is more beneficial. Option D) Five small meals per day with a bedtime snack is a specific dietary pattern that may work for some individuals with diabetes, but it is not a universal recommendation. The frequency and timing of meals should be individualized based on factors like medication regimen, lifestyle, and glucose control goals. In an educational context, it is important to emphasize evidence-based nutrition therapy goals for patients with type 2 diabetes. Educating patients on the importance of maintaining normal serum glucose and lipid levels through a balanced and personalized diet can empower them to take control of their health and effectively manage their condition. Encouraging a holistic approach to nutrition that considers individual preferences, cultural factors, and lifestyle habits can lead to sustainable changes and improved outcomes in diabetes management.

Correct Answer: C

Rationale: The correct answer to the question is option C) Atenolol (Tenormin). Atenolol is a beta-blocker commonly used in the treatment of thyrotoxicosis to block the effects of sympathetic nervous system stimulation caused by excess thyroid hormone levels. Option A) Potassium iodide is used in thyroid storm to block thyroid hormone release, not to block the effects of sympathetic nervous stimulation. Option B) Propylthiouracil (PTU) is an antithyroid medication that inhibits the synthesis of thyroid hormones but does not directly address the sympathetic nervous system stimulation seen in thyrotoxicosis. Option D) Radioactive iodine (RAI) is used to destroy thyroid tissue in conditions like hyperthyroidism and thyroid cancer; however, it does not directly block sympathetic nervous system effects. Educationally, understanding the appropriate medications for managing thyrotoxicosis is crucial for healthcare professionals, especially in endocrinology and internal medicine. Knowing the specific mechanisms of action of each medication helps in making informed decisions regarding patient care and treatment plans. Atenolol's role as a beta-blocker in this context highlights the importance of addressing both the hormonal imbalance and the associated symptoms for comprehensive patient management.

Correct Answer: B

Rationale: In this scenario, the correct collaborative care the nurse should expect for a patient with Addison's disease presenting with symptoms of nausea, vomiting, diarrhea, and fever is IV administration of hydrocortisone (Option B). The rationale behind this is that Addison's disease is characterized by adrenal insufficiency, leading to a deficiency in cortisol production. During times of stress or illness, such as in this case, the body requires higher levels of cortisol to manage the physiological response. Therefore, administering exogenous hydrocortisone helps to replace the deficient cortisol, stabilize the patient's condition, and prevent an adrenal crisis. Option A, IV administration of vasopressors, is incorrect because vasopressors are used to increase blood pressure in conditions like shock, not to address adrenal insufficiency. Option C, IV administration of D5W with 20 mEq KCl, is incorrect as it is a solution for fluid and potassium replacement but does not address the underlying cortisol deficiency seen in Addison's disease. Option D, parenteral injections of adrenocorticotropic hormone (ACTH), is also incorrect as the primary treatment for Addison's disease is cortisol replacement, not ACTH administration. Understanding the appropriate collaborative care for patients with endocrine disorders like Addison's disease is crucial for nurses to provide safe and effective care. Recognizing the signs and symptoms of adrenal insufficiency and knowing the appropriate interventions can prevent potentially life-threatening complications in these patients.

Correct Answer: A

Rationale: The correct answer to the question "In evaluating the effectiveness of a new insulin dosage for a diabetic patient, the nurse would check the urine for sugar and acetone (Option A)" is grounded in the principles of diabetes management and monitoring. Checking the urine for sugar and acetone is a critical aspect of monitoring insulin dosage effectiveness in diabetic patients. When insulin is administered, its primary role is to facilitate the uptake of glucose into cells for energy production. Therefore, by monitoring urine for sugar (glucose) levels, healthcare providers can assess if the insulin dosage is effectively lowering blood glucose levels. Additionally, checking for acetone in the urine is important because in uncontrolled diabetes, the body may start breaking down fats for energy, leading to the production of ketones like acetone. The presence of acetone in the urine can indicate a state of diabetic ketoacidosis, which requires immediate medical attention. Analyzing the other options: B) Collecting a 24-hour urine specimen for acetone determination is not a practical or necessary method for evaluating the effectiveness of insulin dosage. Spot checks for acetone in the urine are sufficient for routine monitoring. C) Weighing the patient daily is not directly related to evaluating the effectiveness of insulin dosage. Weight changes can be influenced by various factors beyond insulin dosage adjustments. D) Rotating the site of injection is important for insulin administration to prevent lipodystrophy (changes in fat tissue) and ensure optimal insulin absorption. While site rotation is a good practice, it is not directly linked to evaluating the effectiveness of a new insulin dosage. In an educational context, understanding the rationale behind monitoring parameters for diabetic patients is crucial for nurses and healthcare professionals involved in diabetes care. Effective monitoring helps in optimizing insulin therapy, preventing complications, and promoting better patient outcomes. This question highlights the significance of urine analysis in diabetes management and reinforces the importance of evidence-based practice in nursing care.

Correct Answer: C

Rationale: The correct answer to the question is option C: Urine test negative for sugar and acetone. This choice indicates that the patient has learned the health teaching about diet and insulin administration. Here's a detailed educational rationale for this question: Correct Answer (Option C): When a patient's urine test is negative for sugar and acetone, it suggests that their blood glucose levels are under control. This outcome indicates that the patient has understood and implemented the teachings about diet and insulin administration effectively. By maintaining stable blood sugar levels, the patient is following the prescribed diet and insulin regimen, which is crucial for managing diabetes. Incorrect Answers: A) A weight gain of 6 lb: Weight gain can be a sign of poor diabetes management, indicating uncontrolled blood sugar levels. It is not a desirable outcome in this context. B) An elevated blood glucose: Elevated blood glucose levels would indicate that the patient has not effectively learned to manage their diabetes through diet and insulin administration. D) Beginning hypertrophy at an injection site: Hypertrophy at the injection site can occur due to improper insulin administration techniques, such as not rotating injection sites. It is not a positive indicator of effective learning. Educational Context: In teaching about the endocrine system, particularly diabetes management involving diet and insulin administration, it is crucial for patients to understand the principles of maintaining blood glucose levels within the target range. Monitoring urine for sugar and acetone levels is a common practice to assess blood glucose control. Educating patients on these aspects empowers them to make informed decisions regarding their health and ensures better management of their condition. In conclusion, monitoring urine for sugar and acetone provides a direct indicator of how well a patient is managing their diabetes through diet and insulin administration. This outcome demonstrates the application of knowledge into practice, leading to improved health outcomes for the patient.