The client with diabetes mellitus reports having difficulty ...

[chandani]

The client with diabetes mellitus reports having difficulty cutting his toenails. The nurse assesses the toenails and notes the nails are thick and ingrown. Which of the following recommendations should be provided to the client?
 
  1. Cut the nails straight across with a clipper after the bath.
   2. Make an appointment with a nail shop for a pedicure.
   3. Make an appointment with a podiatrist.
   4. Offer to file the tops of the nails to reduce thickness after cutting.

Question 2

For the client with cirrhosis, the nurse should evaluate which diagnostic studies to prevent complications associated with bleeding? (Select all that apply.)
 
  1. Complete blood count
   2. Coagulation studies
   3. Albumin
   4. Ammonia levels
   5. Liver functions studies

[ky860224]

Answer to Question 1

3. Make an appointment with a podiatrist.

Rationale:
The toenails of the client with diabetes require close care. If the nails are thick or ingrown, they require the attention of a podiatrist. Cutting the nails across after the bath is correct for toenails that do not demonstrate the complications listed. The client with diabetes is at an increased risk for infection and should avoid situations in which this risk is increased, such as the nail shop pedicure. The nurse should not cut the nails of the client.

Answer to Question 2

1. Complete blood count
2. Coagulation studies

Rationale:
The complete blood count (CBC) is performed to evaluate red blood cells, hemoglobin, and hematocrit, as well as the platelet count. When the lab values of the CBC are low, this is associated with bleeding. Albumin levels are obtained to reflect liver impairment. Ammonia levels are obtained to determine liver function; elevated ammonia levels are due to the liver's inability to convert ammonia to urea for renal excretion. When liver functions are elevated, they reflect liver impairment.

[chandani]

Excellent

[kjohnson]

TYSM