A patient who has diabetes and uses insulin to control blood ...

[s.tung]

A patient who has diabetes and uses insulin to control blood glucose has been NPO since midnight before having a knee replacement surgery. Which action should the nurse take?
 
  a. Withhold the usual scheduled insulin dose because the patient is NPO.
  b. Obtain a blood glucose measurement before any insulin administration.
  c. Give the patient the usual insulin dose because stress will increase the blood glucose.
  d. Administer a lower dose of insulin because there will be no oral intake before surgery.

Question 2

The nurse is preparing to witness the patient signing the operative consent form when the patient says, I do not really understand what the doctor said. Which action is best for the nurse to take?
 
  a. Provide an explanation of the planned surgical procedure.
  b. Notify the surgeon that the informed consent process is not complete.
  c. Administer the prescribed preoperative antibiotics and withhold any ordered sedative medications.
  d. Notify the operating room staff that the surgeon needs to give a more complete explanation of the procedure.

[janeli]

Answer to Question 1

ANS: B
Preoperative insulin administration is individualized to the patient, and the current blood glucose will provide the most reliable information about insulin needs. It is not possible to predict whether the patient will require no insulin, a lower dose, or a higher dose without blood glucose monitoring.

Answer to Question 2

ANS: B
The surgeon is responsible for explaining the surgery to the patient, and the nurse should wait until the surgeon has clarified the surgery before having the patient sign the consent form. The nurse should communicate directly with the surgeon about the consent form rather than asking other staff to pass on the message. It is not within the nurse's legal scope of practice to explain the surgical procedure. No preoperative medications should be administered until the patient understands the surgical procedure and signs the consent form.

[s.tung]

Excellent

[kusterl]

TYSM