A client who was diagnosed with diabetes mellitus 1 year ago is ...

[student77]

A client who was diagnosed with diabetes mellitus 1 year ago is hospitalized in diabetic ketoacidosis after a religious fast. The client tells the nurse, I have fasted during this season every year since I became an adult.
 
  I am not going to stop now. The nurse is not knowledgeable about this particular religion. Which nursing actions would be appropriate?
  Select all that apply.
  A) Request a consult from a diabetes educator.
  B) Tell the client that things are different now because of the diabetes.
  C) Ask family members of the same religion to discuss fasting with the client.
  D) Assess the meaning and context of fasting in the client's religion.
  E) Encourage the client to seek medical care if signs of ketoacidosis occur in the future.

Question 2

The nurse is instructing a client with a history of acidosis on the use of sodium bicarbonate. Which client statement indicates that additional teaching is needed?
 
  A) I should contact the doctor if I have any gastric discomfort with chest pain.
  B) I need to purchase antacids without salt.
  C) I should use the antacid for at least 2 months.
  D) I should call the doctor if I get short of breath or start to sweat with this medication.

[pocatato]

Answer to Question 1

Answer: A, D, E

The diabetes educator should be contacted to work with the client on strategies that might allow the fasting to occur in a safe manner. Assessing the meaning and context of fasting in the client's religion would be educative for the nurse and an appropriate action. Stressing the importance of promptly seeking care when signs of ketoacidosis occur helps to promote the client's health and is appropriate. Telling the client that life is different now does not support religious beliefs. Asking the family to talk to the client might help, but the diabetes educator would be able to provide more direct and helpful information for the client.

Answer to Question 2

Answer: C

The client should be instructed to immediately contact the primary healthcare provider if gastric discomfort occurs with chest pain or if dyspnea or diaphoresis occurs. The client should be instructed to use non-sodium antacids to prevent the absorption of excess sodium or bicarbonate into systemic circulation and to not use any bicarbonate antacid for longer than 2 weeks.

[student77]

Gracias!

[connor417]

Thanks for the timely response, appreciate it