Author Question: A nurse assesses a client with diabetes mellitus who self-administers subcutaneous insulin. The ... (Read 49 times)

sam.t96 · **on:** Jun 25, 2018

A nurse assesses a client with diabetes mellitus who self-administers subcutaneous insulin. The nurse notes a spongy, swelling area at the site the client uses most frequently for insulin injection. Which action should the nurse take?

a. Apply ice to the site to reduce inflammation.
b. Consult the provider for a new administration route.
c. Assess the client for other signs of cellulitis.
d. Instruct the client to rotate sites for insulin injection.

Question 2

A nurse assesses a client who is being treated for hyperglycemic-hyperosmolar state (HHS). Which clinical manifestation indicates to the nurse that the therapy needs to be adjusted?

a. Serum potassium level has increased.
b. Blood osmolarity has decreased.
c. Glasgow Coma Scale score is unchanged.
d. Urine remains negative for ketone bodies.

durant1234 · **Reply #1 on:** Jun 25, 2018

Answer to Question 1

ANS: D
The client's tissue has been damaged from continuous use of the same site. The client should be educated to rotate sites. The damaged tissue is not caused by cellulitis or any type infection, and applying ice may cause more damage to the tissue. Insulin can only be administered subcutaneously and intravenously. It would not be appropriate or practical to change the administration route.

Answer to Question 2

ANS: C
A slow but steady improvement in central nervous system functioning is the best indicator of therapy effectiveness for HHS. Lack of improvement in the level of consciousness may indicate inadequate rates of fluid replacement. The Glasgow Coma Scale assesses the client's state of consciousness against criteria of a scale including best eye, verbal, and motor responses. An increase in serum potassium, decreased blood osmolality, and urine negative for ketone bodies do not indicate adequacy of treatment.