Endocrine NCLEX questions
The nurse cares for a client with type 2 diabetes mellitus and hemoglobin A1C results of 8% at an outpatient health clinic. Which statement by the nurse will best address these results?
"let's review you diet, exercise, and medication regimen for the past 2-3 months" explanation: Hemoglobin A1C is a diagnostic test used to measure the percentage of glycosylated hemoglobin in the blood over a period of 2-3 months. A normal hemoglobin A1C is 4%-6% in clients without diabetes; the goal is to keep the level <7% in clients with diabetes.
A client with type 1 diabetes mellitus is on intensive insulin therapy. The client is of the Islamic faith and insists on fasting during Ramadan. What is the most important nursing action?
assess the client's clinical stability and glycemic control explanation: Clients with diabetes who insist on fasting for religious reasons need to be assessed for risk of adverse events. Key assessment areas include clinical stability and glycemic control (eg, history of hyper-/hypoglycemic episodes, medication regimen, and the ability to self-monitor blood glucose during the fast).
The nurse cares for a group of clients on a medical surgical floor. The client with which condition is at highest risk for developing syndrome of inappropriate antidiuretic hormone (SIADH)?
small cell lung cancer explanation: ADH is sometimes produced and secreted by cancer cells, especially lung cancer cells causing SIADH, a condition in which too much ADH causes water retention, increased total water, and dilutional hyponatremia.
The nurse cares for a client who is experiencing exophthalmos as a complication of Graves' disease. Which nursing action(s) should be included in the client's plan of care? Select all that apply.
1. administer artificial tears to moisten the conjunctiva 2. if eyelids don't close, tape them during sleep 3. recommend use of dark glasses to prevent irritation 4. teach about the importance of smoking cessation explanation: Exophthalmos is a complication of hyperthyroidism from Graves' disease leading to increased orbital tissue (connective, adipose, muscular) expansion that can be irreversible. Nursing care to keep eyes moist and protected is needed to prevent corneal ulcers and infection.
The nurse is planning care for a client immediately following a thyroidectomy. Which of the following nursing actions are appropriate to include in the plan of care? Select all that apply.
1. assessing frequently for facial or extremity numbness or tingling 2. ensuring that a tracheostomy insertion kit is at the bed side at all times 3. maintaining head of bed 30-45 degrees 4. monitoring client's voice strength and quality explanation: Following a thyroidectomy, place the client in semi-Fowler position with a neutral head and neck position. Keep a tracheostomy kit, suction, and oxygen at the bedside in case airway compromise develops. Monitor frequently for signs of hypocalcemia and changes in voice strength and quality.
The emergency department nurse cares for a client admitted with a diagnosis of hyperosmolar hyperglycemic state. The nurse understands which characteristics are commonly associated with this complication? Select all that apply.
1. blood glucose > 600mg/dL 2. hx of type 2 diabetes 3. neurological manifestations explanation: Hyperosmolar hyperglycemic state differs from diabetic ketoacidosis in that it is typically associated with type 2 diabetes mellitus. Because these clients produce some insulin, severe hyperglycemia happens more slowly and is often not noted until neurological manifestations occur.
The clinic nurse is taking vital signs on a client who reports being fatigued every day and gaining weight lately despite not eating much. The nurse should also ask about which symptoms? Select all that apply.
1. cold intolerance 2. constipation 3 menstrual irregularities explanation: Hypothyroidism is associated with symptoms of a low metabolic rate; hyperthyroidism causes symptoms of a high metabolic rate
The nurse is conducting a health-screening clinic at an industrial work site. The nurse should be most concerned about which client's risk for metabolic syndrome?
55 yo woman with waist circumference of 37 inches, triglycerides of 190 mg/dL, fasting blood glucose of 120 mg/dL explanation: Clients with metabolic syndrome are at increased risk for stroke, diabetes mellitus, and cardiovascular disease. Criteria for metabolic syndrome include at least 3 of 5 conditions: abdominal obesity, hyperglycemia, low levels of high-density lipoprotein, high serum triglycerides, and hypertension.
The nurse cares for a client with type 1 diabetes mellitus who is obtunded and responding to only painful stimuli. A STAT blood sample reveals a blood glucose level of 38 mg/dL (2.11 mmol/L). Which initial action by the nurse is best?
administer 50% dextrose in water IV push explanation: Hypoglycemia is a complication of diabetes mellitus that can lead to coma, seizures, and death without prompt intervention. Nurses caring for clients with hypoglycemia and altered mental status should administer IV glucose to quickly restore blood glucose levels. Lifesaving treatment should not be delayed to perform further assessments.
A client is diagnosed with diabetic ketoacidosis (DKA). The client reports frequent urination, thirst, and weakness. The nurse assesses a temperature of 102.4 F (39.1 C), fruity breath, deep labored respirations with a rate of 30/min, and dry mucous membranes. What is the priority nursing diagnosis (ND) at this time?
deficient fluid volume related to osmotic diuresis explanation: Hyperglycemia associated with DKA leads to osmotic diuresis, dehydration, electrolyte imbalance, and possible hypovolemic shock and renal failure. Deficient fluid volume related to osmotic diuresis is an appropriate ND for a client with DKA
The nurse cares for a client with type 2 diabetes mellitus. The client is alert and oriented but also shaky, pale, and diaphoretic. The client's fingerstick blood glucose is 50 mg/dL (2.8 mmol/L). Which of the following is the best next step the nurse can take?
give 6 oz of orange juice or low fat milk explanation: A client who experiences a hypoglycemic reaction (evidenced by low blood glucose <70 mg/dL [3.9 mmol/L]) and is alert enough to ingest food/liquids orally should be given a simple carbohydrate (eg, orange juice, low-fat milk).
The nurse is performing an initial assessment on a client diagnosed with Addison's disease. Which assessment findings should the nurse anticipate? Select all that apply.
hyperpigmented skin, weight loss explanation: Addison's disease (chronic adrenal insufficiency) leads to hyperpigmented skin, low blood pressure, weight loss, and muscle weakness.
The nurse is assigned to care for a client who had a thyroidectomy 24 hours ago. On initial assessment, which finding requires the most immediate action by the nurse?
laryngeal stridor explanation: Stridor indicates airway obstruction, and abrupt onset is a medical emergency. Stridor after thyroidectomy requires immediate action by the nurse to maintain airway patency. Suctioning devices, oxygen, and a tracheostomy tray should be available for rapid surgical intervention.
The nurse assesses a client who had a thyroidectomy 8 hours ago. The nurse finds the client anxious, with tingling around the mouth and muscle twitching in the right arm. Which action is most important for the nurse to implement first?
obtain a serum calcium level explanation: Normal serum calcium is 8.6-10.2 mg /dL (2.15-2.55 mmol/L). Hypocalcemia (serum calcium <8.6 mg/dL [2.15 mmol/L]) is a potential complication of thyroidectomy. The nurse should monitor for signs and symptoms of tetany (tingling of hands, toes, and circumoral region; positive Trousseau or Chvostek sign), confirm with serum calcium results, and administer calcium gluconate as prescribed. Untreated clients can develop life-threatening laryngeal spasm.
The nurse cares for a client with type 1 diabetes mellitus. Which laboratory result is most important to report to the primary health care provider?
serum creatinine of 2.0 mg/dL (177 mol/L) explanation: The normal serum creatinine for an adult is 0.6-1.3 mg/dL (53-115 µmol/L). Serum creatinine provides an estimation of the glomerular filtration rate and is an indicator of kidney function. The client with diabetes mellitus is at risk for diabetic nephropathy, a complication associated with microvascular blood vessel damage in the kidney. Early treatment and tight control of blood glucose levels are indicated to prevent progressive renal injury in a client with diabetic nephropathy.
A client is admitted to the intensive care unit with suspected pheochromocytoma. The client's vital signs are temperature of 99.6 F (37.5 C), blood pressure (BP) of 200/110 mm Hg, heart rate of 110/min, and respirations of 20/min. The client is sweating profusely and reports a severe headache. Which prescription should the nurse implement first?
start nitroprusside infusion at 0.5 mcg/kg/min explanation: Pheochromocytoma is a condition caused by a tumor in the adrenal medulla that causes release of catecholamines such as epinephrine and norepinephrine, resulting in paroxysmal hypertensive crisis. Hypertensive crisis puts the client at risk for stroke and should be treated promptly with intravenous nitroprusside or another vasodilator (eg, phentolamine, nicardipine). Abdominal palpation should be avoided in these clients
A client diagnosed with septic shock has an upward-trending glucose level (180-225 mg/dL [10.0-12.5 mmol/L]) requiring control with insulin. The client's spouse asks why insulin is needed as the client is not a diabetic. What is the most appropriate response by the nurse?
the increase in glucose is a normal response to stress by the body, we give insulin to keep the leve; at 140-180 mg/dL explanation: Stress-induced hyperglycemia causes complications in the hospitalized client. To minimize complications, the recommended target glucose range for critically ill clients is 140-180 mg/dL [7.8-10.0 mmol/L]. For non-critically ill clients, <140 mg/dL (7.8 mmol/L) fasting and <180 mg/dL (10.0 mmol/L) random blood glucose are recommended.
The nurse in the emergency department is caring for a client recently diagnosed with Graves' disease who was admitted following a motor vehicle accident. The nurse notes the vital signs shown in the exhibit. The nurse alerts the primary health care provider that the client may be experiencing which condition?--> increased vital signs q 1hr
thyroid storm explanation: Thyroid storm is a life-threatening complication of Graves' disease (hyperthyroidism). Assessment findings include a rapid increase in temperature, heart rate, and blood pressure in response to stress.
A client with type I diabetes mellitus is brought to the emergency department by his wife. The client has fruity breath with rapid, deep respirations at 36 breaths per minute, reports abdominal pain, and appears weak. The nurse should anticipate implementation of which prescription(s)? Select all that apply
1. perform finger stick and serum blood glucose test 2. prepare to administer an IV infusion of regular insulin 3. start an IV line and administer a bolus of normal saline explanation: DKA is an acute life-threatening complication, typically of type I diabetes, characterized by hyperglycemia, ketosis, and acidosis. It is caused by an intense deficit of insulin and should be treated first with rehydration (normal saline) and then insulin administration
The nurse educates a 30-year-old female client who is being evaluated for hyperthyroidism with a radioactive iodine uptake (RAIU) test. Which instruction(s) should the nurse include in the teaching plan? Select all that apply.
1. pregnancy test must be taken before exam 2. all jewelry and metal should be removed from neck before exam 3. antithyroid meds should be held 5-7 days prior exam explanation: RAIU measures the metabolic activity in the thyroid gland in order to differentiate between the many types of thyroid disorders. For an accurate measurement, medications affecting the thyroid should be held 7 days prior to the test date and clients are NPO for 4 hours prior to iodine administration. Premenopausal women must take a pregnancy test. Dentures, metal, and jewelry should be removed.
The nurse in the intensive care unit cares for a client with primary adrenocortical insufficiency (Addison's disease). The client reports nausea and abdominal pain. The blood pressure suddenly drops from 120/74 mm Hg to 88/48 mm Hg, heart rate increases from 80 to 100/min, and the client appears confused. Which action should the nurse take first?
administer as needed dose of hydrocortisone IV push explanation: Addisonian crisis is a potentially life-threatening complication of Addison's disease and commonly presents with abdominal pain, hypotension, and hypoglycemia. Emergency management includes shock management with fluid resuscitation using 0.9% normal saline and 5% dextrose, and administration of high-dose hydrocortisone replacement IV push.
A client's diabetes is controlled with a morning dose of glargine and a scheduled, fixed dose of lispro with meals. Before breakfast, the client's fingerstick glucose is 105 mg/dL (5.8 mmol/L). The tray is in the room, and the client is eager to eat. What action should the nurse take?
administer both insulins as prescribed explanation: Rapid-acting insulin (eg, scheduled prandial fixed dosing, correctional sliding-scale dosing) is given if a client plans to eat within 15 minutes. Scheduled prandial insulin prevents hyperglycemia after meals and is held when blood glucose is below normal (70 mg/dL [3.9 mmol/L]). Correctional insulin corrects existing hyperglycemia.
A client is suspected of having Graves' disease (hyperthyroidism). Which signs and/or symptoms are expected to be present in this client? Select all that apply.
anxiety, heart palpitations, protrusion of eyeballs explanation: Hyperthyroidism refers to a sustained hyperfunctioning of the thyroid gland due to an increase in thyroid hormones (T3 and T4). It causes symptoms associated with a high metabolic rate, including weight loss, heart palpitations, heat intolerance, anxiety, hand tremors, and insomnia.
The nurse assesses a female client with a diagnosis of primary adrenal insufficiency (Addison disease). The nurse recognizes which finding associated with the disease?
bronze pigmentation of skin explanation: Addison disease, or primary adrenocortical insufficiency, is also described as hypofunction of the adrenal cortex. The adrenal gland is responsible for secretion of glucocorticoids, androgens, and mineralocorticoids. Bronze hyperpigmentation of the skin in sun-exposed areas is caused by an increase in adrenocorticotropic hormone (ACTH) by the pituitary in response to low cortisol (ie, glucocorticoid) levels (Option 1).
A client with type 1 diabetes is prescribed NPH insulin before breakfast and dinner. Although the client reports feeling well, the 6 AM blood glucose level has averaged 60 mg/dL (3.3 mmol/L) over the past week. Which action is appropriate for the nurse to recommend to the client?
consume a snack of milk and cereal at bedtime explanation: NPH insulin is an intermediate-acting insulin that peaks in 4-12 hours. In asymptomatic clients, the best intervention to prevent low blood glucose levels related to an evening dose of NPH is to consume a bedtime snack of protein and complex carbohydrates.
The nurse is teaching a group of clients diagnosed with diabetes mellitus. Which lesson regarding foot care should be included? Select all that apply.
cut toenails straight across, use mild foot powder on perspiring feet, use cotton or lamb's wool to separate overlapping toes explanation: Individuals with type I or II diabetes mellitus are at increased risk for developing an infection or ulcer on their feet due to the chronic complication of peripheral neuropathy. Clients should keep feet clean, dry, and free from irritation.
The nurse practicing in an out-patient clinic cares for a client recently diagnosed with hyperthyroidism. Which diet-related teaching should the nurse add to the client's plan of care? Select all that apply.
include meals and snacks high in protein content, teach avoidance of caffeine containing liquids, teach client about consumption of of a high caloric diet of 4000-5000 calories/day explanation: Hyperthyroidism leads to a high metabolic rate. It is important for the nurse to teach the client nutritional measures, including consumption of a diet high in calories (high in protein, carbohydrates, vitamins, and minerals) to satisfy hunger and prevent weight loss and tissue wasting.
The nurse teaches proper foot care to a client with diabetes mellitus. Which statement by the client indicates that further teaching is needed?
"I will make sure my flip flops are made out of leather" explanation: Careful, daily attention to foot care can prevent long-term complications. Clients with diabetes should be taught to wear closed-toed, leather-based shoes to prevent injury. Clients should also receive instruction regarding daily hygiene and inspection, injury avoidance, and prompt reporting of problems.
The nurse reviews prescriptions for assigned adult clients. Which prescription should the nurse question?
0.45% of NaCl solution prescribed for a client with SIADH secretion who has a sodium level of 120mEq/L
In the intensive care unit, the nurse cares for a client admitted with a head injury who develops syndrome of inappropriate antidiuretic hormone. Which data should the nurse expect with the onset of this condition? Select all that apply.
1. decreased serum osmolality 2. high urine specific gravity 3. low serum sodium explanation: Syndrome of inappropriate antidiuretic hormone (SIADH) is potential complication of head injury. In SIADH, the extra ADH leads to excessive water absorption by the kidneys. Low serum osmolality and low serum sodium are the result of increased total body water (dilution). As ADH is secreted and water is retained, urine output is decreased and concentrated, resulting in a high specific gravity.
When no changes are made to the diet or prescribed insulin, which client with type 1 diabetes mellitus does the nurse anticipate having the highest risk of developing hypoglycemia?
40 yo male who is experienced cyclist that rides extra 10 miles explanation: Aerobic exercise typically lowers blood glucose levels as glucose production in the liver fails to keep up with elevated glucose uptake by the muscles at work.
A nurse is teaching a nutrition class for clients with newly diagnosed type 2 diabetes. Which meal represents the best adherence to the principles of and recommendations for diabetic meal planning?
black bean chili with brown rice, mixed green salad explanation: Clients with diabetes should eat foods with a low glycemic index and high fiber content. Saturated fats and sodium should be restricted.
The nurse is caring for an adolescent client diagnosed with type 1 diabetes. The client exhibits hot, dry skin and a glucose level of 350 mg/dL (19.4 mmol/L). Arterial blood gases show a pH of 7.27. STAT serum chemistry labs have been drawn. Cardiac monitoring shows a sinus rhythm with peaked T waves, and the client has minimal urine output. What is the nurse's next priority action?
administer normal saline infusion explanation: Clients with diabetic ketoacidosis and hyperosmolar hyperglycemic state require IV normal saline as a priority due to severe dehydration. Once fluids are given as a bolus, insulin is initiated. The serum potassium levels can be elevated in the initial stages despite a low total body potassium. Potassium repletion is started once the serum potassium levels are normalized or trending low (from elevated levels).
In the intensive care unit, the nurse cares for a client who develops diabetes insipidus (DI) 2 days after pituitary adenoma removal via hypophysectomy. Which intervention should the nurse implement?
administer desmopressin explanation: DI occurs when there is insufficient production/suppression of ADH. It is characterized by polydipsia and polyuria with diluted urine. Oral and/or intravenous fluid replacement is imperative to prevent dehydration. DI is treated with ADH replacement drugs (eg, desmopressin acetate [DDAVP]). Clients should be monitored for urine output, urine specific gravity, and serum sodium.
The nurse is caring for a client with suspected Graves disease. Which assessment finding requires priority intervention?
agitation an confusion explanation: Thyroid storm is a life-threatening complication of Graves disease. Fever, altered mentation, and excess autonomic activity (eg, severe hypertension, tachycardia) are common. Early recognition and treatment are crucial.
The nurse cares for a client with Addison's disease who was involved in a motor vehicle accident and hospitalized for a fracture of the right femur. Which client information is most important to report to the primary health care provider (PHCP)?
blood pressure change from 128/80mm Hg to 90/50 mm Hg explanation: Addison's disease is adrenocortical insufficiency or hypofunction of the adrenal cortex. A potential life-threatening complication is Addisonian crisis. Signs and symptoms include hypotension, tachycardia, hyperkalemia, hyponatremia, hypoglycemia, fever, weakness, and confusion; these should be reported to the PHCP immediately.
The clinic nurse is reviewing the laboratory results of a 35-year-old client who reports fatigue for the last month. Based on the laboratory results, which additional clinical manifestations would the nurse expect? Click on the exhibit button for additional information. Select all that apply. --> low T3 and T4 levels and high TSH levels
bradycardia, cold intolerance, constipation, hair loss explanation: Primary hypothyroidism is a condition identified by low thyroid hormone and elevated thyroid-stimulating hormone levels, which result in decreased metabolic function throughout the body. Clinical manifestations include weight gain, constipation, dry skin, hair loss, cold intolerance, bradycardia, and confusion.
The nurse in the endocrinology clinic is reviewing phone messages from clients. Which client would be the priority to call first?
client with hyperthyroidism who has a new temperature reading of 101.5F explanation: Clients with hyperthyroidism are at risk for developing thyroid storm, a life-threatening condition. Symptoms include fever, tachycardia, cardiac dysrhythmias, nausea, vomiting, diarrhea, and altered mental status. Client management includes reducing fever, maintaining hydration, and preventing cardiac compromise.
The nurse teaches disease management to a group of clients with type I diabetes mellitus. Which of the following should the nurse teach as signs or symptoms associated with hypoglycemia? Select all that apply.
diaphoresis, pallor, trembling explanation: Hypoglycemia (blood glucose <70 mg/dL [3.9 mmol/L]) is an acute and potentially serious complication. Signs and symptoms include shakiness, palpitations, anxiety/arousal, restlessness, diaphoresis, and pallor.
The nurse is assessing a group of clients in the community health clinic for metabolic syndrome. Which clients exhibit features of the syndrome? Select all that apply.
female with waist circumference of 38 inches, female with bp of 148/90mm Hg, male with triglyceride level of 201 mg/dL explanation: Features of metabolic syndrome include increased waist circumference, elevated blood pressure, increased triglycerides, decreased HDL, and increased fasting blood glucose. The mnemonic is "We Better Think High Glucose" (Waist circumference, Blood pressure, Triglyceride, HDL, Glucose).
The nurse cares for a client admitted to the hospital due to confusion. The client has a nonmetastatic lung mass and a diagnosis of syndrome of inappropriate antidiuretic hormone (SIADH). Which action(s) should the nurse expect to implement? Select all that apply.
fluid restriction, seizure precautions, strict record of fluid intake and output explanation: SIADH can occur due to lung cancer and is characterized by water retention, increased total body water, and dilutional hyponatremia. Hyponatremia may cause neurologic complications (eg, confusion, seizures). SIADH treatment includes fluid restriction, oral salt tablets, and administration of 3% saline IV and/or vasopressin receptor antagonists.
A client is admitted to the intensive care unit with diagnoses of a brain tumor complicated by transient diabetes insipidus. Which client data related to this complication should the nurse expect? Select all that apply.
high serum osmolality, low urine specific gravity, reports of excessive thirst explanation: Diabetes insipidus is a condition in which antidiuretic hormone is insufficiently produced or suppressed, resulting in polydipsia and polyuria (up to 20 L/day). Urine is copious and dilute with a low specific gravity (<1.003). Fluid volume deficit can lead to dehydration, hypernatremia, high serum osmolality, and weight loss.
The nurse assesses a client with Cushing syndrome. Which clinical manifestations should the nurse expect? Select all that apply.
hyperglycemia, hypertension, truncal obesity explanation: Clinical manifestations of Cushing syndrome include weight gain, truncal obesity, moon face, skin atrophy, easy bruising, purple striae on the abdomen, muscle weakness, hypertension, and hyperglycemia. Associated androgen excess can result in acne, hirsutism, and menstrual irregularities.
In the intensive care unit, the nurse cares for a client who has been admitted with diabetic ketoacidosis. The client is on a continuous infusion of regular insulin at 5 units/hr via IV pump. Which action should the nurse expect to implement?
initiate potassium IV when serum potassium is 3.5 - 5.0 mEq/L explanation: Hypokalemia often occurs with resolution of diabetic ketoacidosis and administration of IV insulin, which shifts potassium from the intravascular to the intracellular space. Potassium is administered even when the client is normokalemic (3.5-5.0 mEq/L [3.5-5.0 mmol/L]) to prevent life-threatening arrhythmias.
The nurse is giving report to a licensed practical nurse (LPN) who will be helping to monitor a client who just had a total thyroidectomy. What will the nurse emphasize as most important to report immediately?
noisy breathing explanation: Airway swelling is a life-threatening complication of thyroid surgery. Signs of respiratory distress such as stridor and dyspnea require rapid intervention.
The nurse assesses a client with hyperparathyroidism who had a parathyroidectomy 4 hours ago. Which assessment technique should the nurse use to check for complications in this client?
place bp cuff on arm, inflate to pressure, > than systolic BP, and hold in place for 3 minutes explanation: Normal serum calcium is 8.6-10.2 mg/dL (2.15-2.55 mmol/L). Hypocalcemia (serum calcium <8.6 mg/dL [2.15 mmol/L]) is a potential complication of parathyroidectomy. The nurse should check for Trousseau's (spasm of muscle and arm) and Chevostek's (tapping face) signs as early indications of hypocalcemia.
The nurse is caring for a 72-year-old client with hypothyroidism admitted to the emergency department for altered mental status. The client lives alone but has not taken medications or seen a health care provider for several months. Which action is the priority? -> low O2 sat and vitals
prepare endotracheal intubation explanation: Myxedema coma is a state of severe hypothyroidism and decreased level of consciousness that may progress to coma and respiratory failure. The nurse should provide respiratory support (eg, ventilation with a bag-valve-mask) and prepare to assist with intubation.
The nurse assesses a 40-year-old client with acromegaly in an outpatient health clinic. Which new finding is most important to report to the health care provider?
presence of S3 and S4 heart sound explanation: Acromegaly is an uncommon condition caused by growth hormone overproduction leading to overgrowth of soft tissues of the face, hands, feet, and organs. The nurse should monitor the client for signs and symptoms of acute complications (eg, heart failure) and report findings to the health care provider.
The nurse cares for a client diagnosed with type I diabetes mellitus who came to the emergency department with the acute complication of diabetic ketoacidosis (DKA). After checking the blood glucose, which prescription should the nurse implement first?
start an IV line and infuse normal saline as prescribed explanation: The severe hyperglycemia of diabetic ketoacidosis (DM1) and hyperosmolar hyperglycemic state (DM2) causes severe dehydration from an osmotic diuresis. IV normal saline resuscitation should be started before any other therapy
The nurse cares for a newly admitted client with type 1 diabetes mellitus. The nurse reviews the electronic health record before the breakfast trays arrive on the unit and contacts the health care provider for which reason? Click on the exhibit button for additional information
to request a prescription of lispro explanation: Rapid-acting insulin preparations are administered to correct hyperglycemia, whereas long-acting insulin preparations prevent hyperglycemia. The nurse should question a spironolactone prescription and notify the health care provider if the client is hyperkalemic.