Author Question: The nurse receives a telephone laboratory report indicating that a diabetic client has a ... (Read 121 times)

Zoey63294 · **on:** Jul 22, 2018

The nurse receives a telephone laboratory report indicating that a diabetic client has a glycosylated hemoglobin A1c level of 7.6. The nurse plans to provide diabetic teaching in which of the following priority areas?

1. Avoidance of infection
2. Rotation of insulin injection sites
3. Measures to prevent hyperglycemia
4. Avoidance of hypoglycemic episodes

Question 2

The nurse is caring for a child who fractured the ulna bone and had a cast applied 24 hours ago. The child tells the nurse that the arm feels like it is falling asleep. Which of the following nursing actions would be most appropriate?

1. Report the findings to the physician.
2. Document the findings, and reassess the situation in 4 hours.
3. Encourage the child to keep the arm elevated for the next 24 hours.
4. Tell the child that this is normal and will disappear when the cast is dry.

kkenney · **Reply #1 on:** Jul 22, 2018

Answer to Question 1

3

Rationale: The normal level for glycosylated hemoglobin A1c is 4 to 6. This test measures the amount of glucose that has become permanently bound to the red blood cells (RBCs) from circulating glucose. Elevations in the blood glucose level will cause elevations in the amount of glycosylation, helping to detect otherwise unknown episodes of hyperglycemia. Elevations indi-cate continued need for teaching related to the prevention of hyperglycemic episodes because the results are reflective of the blood glucose levels over the preceding 2- to 3-month period.

Answer to Question 2

1

Rationale: A child's complaint of pins and needles or of the extremity falling asleep needs to be reported to the physician. These complaints indicate the possibility of circulatory impairment and paresthesia. Paresthesia is a serious concern because paralysis can result if the problem is not corrected. The five P's of vascular impairment are pain, pallor, pulselessness, paresthesia, and paralysis. Prompt intervention is critical if neurovascular impairment is to be prevented.