Author Question: The older adult who has type 2 diabetes mellitus has a sensory impairment and unstable blood sugar ... (Read 25 times)

tichca · **on:** Jul 11, 2018

The older adult who has type 2 diabetes mellitus has a sensory impairment and unstable blood sugar levels. Which of the following alterations in sensory function does the nurse address in the plan of care for stabilizing the blood sugar?

a. Requires reading glasses at 2.0 strength.
b. Has difficulty hearing in crowded rooms.
c. Enjoys spicy food more than bland food.
d. Awakens with periodic left-foot numb-ness.

Question 2

An older woman who has diabetes mellitus takes glipizide (Glucotrol) and tells the nurse that her blood sugar levels have been higher than normal since she began using a vaginal cream for hot flashes.

Which one of the following interventions is the best for the nurse to implement? a. Ask the patient if she has had a fever or infection recently.
b. Verify the expiration date of the medica-tion.
c. Review her diet for increased carbohy-drates.
d. Ascertain whether the vaginal cream con-tains estrogen.

cascooper22 · **Reply #1 on:** Jul 11, 2018

Answer to Question 1

B
The nurse focuses on the hearing impairment to plan care for stabilizing this patient's blood glu-cose level; hearing impairment is a factor that affects blood glucose control in older adults with diabetes mellitus. Reading glasses at 2.0 are medium-strength glasses, and the need for such glasses is common and not considered a visual impairment. A preference for spicy food does not indicate an impaired sense of taste. Although numbness is a sensory impairment, episodic numbness associated with sleeping is more likely to be due to a poorly positioned extremity.

Answer to Question 2

D
Vaginal cream prescribed for hot flashes potentially contains estrogen as an active ingredient; estrogen is effective therapy to reduce hot flashes. Unfortunately, estrogen impairs the hypogly-cemic effect of sulfonylurea hypoglycemic medications. If the estrogen therapy continues, then the nurse should assist this individual in adjusting her diet and exercise regimen in coordination with her antidiabetic medication to maintain stable blood sugar levels. Asking whether she has had a fever or infection recently is a reasonable question because infection increases the blood sugar of an individual with diabetes mellitus; however, because the hyperglycemia is associated with the vaginal cream, the most likely contributor to the problem is the vaginal cream, which is a good place to start the investigation. Verifying the expiration date of the medication is a rea-sonable task to implement; however, ineffective medication would not have the desired hypog-lycemic effect. Reviewing her diet for increased carbohydrates is a reasonable task to implement because a glucose load will increase blood sugar levels.