Author Question: A patient who has recently developed prediabetic symptoms is overweight and has a sedentary ... (Read 32 times)

Awilson837 · **on:** Jul 24, 2018

A patient who has recently developed prediabetic symptoms is overweight and has a sedentary lifestyle. The primary care NP has prescribed an oral antidiabetic agent.

The patient says, I suppose I'll need insulin like my mother and grandfather did. To educate this patient about managing this disease, the NP should initially: a. determine how the patient feels about using insulin.
b. provide written educational materials about diet and exercise.
c. compare the actions of oral antidiabetic agents with insulin injections.
d. tell the patient that the medication plus exercise may prevent the need for insulin.

Question 2

A patient is diagnosed with asthma. The primary care nurse practitioner (NP) prescribes an inhaled corticosteroid and an inhaled bronchodilator medication and provides education about how to use inhalers.

At a follow-up visit 2 weeks later, the patient's pulmonary function tests are worse. The NP should: a. provide a detailed written asthma action plan for the patient.
b. ask the patient to describe how the medications have been used.
c. review the symptoms of an acute asthma exacerbation with the patient.
d. teach the patient to use the albuterol more often and order an oral steroid.

diana chang · **Reply #1 on:** Jul 24, 2018

Answer to Question 1

A
When beginning an education program for patients, it is first necessary to determine the patient's motivation and desire to learn. Asking this patient about feelings about using insulin would help the NP understand how this possibility might motivate the patient to learn about prediabetic management. The other options all are legitimate parts of a teaching plan but cannot be used effectively until the patient and the provider have negotiated what the patient wants to know.

Answer to Question 2

B
Follow-up visits present an opportunity for the NP to evaluate learning. A first step when symptoms have not improved is to ask the patient to describe what he or she does. A detailed written plan and a review of asthma symptoms are a part of education but should have been given at the initial visit along with hands-on instruction and demonstrations. Until it is determined whether or not the patient understands and follows the prescribed regimen, it is not correct to change the plan of care.