Author Question: The nurse is caring for a client who arrives in the emergency room obtunded. The client's blood ... (Read 156 times)

tnt_battle · **on:** Jul 22, 2018

The nurse is caring for a client who arrives in the emergency room obtunded. The client's blood sugar is 802 and the client is started on an insulin drip.

The nurse plans to monitor that the blood sugar does not decrease by more than 50 every hour for which of the following reasons? 1. Increased risk for increased intracranial pressure
2. Increased risk for the development of diabetic coma
3. Increased risk for cardiac arrhythmias
4. Increased risk of fluid deficit

Question 2

After an assessment of a new client, a nursing student expresses a belief that it is hopeless to keep providing substance abuse treatment when the rate of relapse is so high.

The staff nurse should respond with which of the following statements? 1. Sometimes a client doesn't show much effort..
2. You are right. I don't know why we bother..
3. It is important to maintain hope that a client can make positive change..
4. We are legally obligated to provide care..

amy.lauersdorf90 · **Reply #1 on:** Jul 22, 2018

Answer to Question 1

1. Increased risk for increased intracranial pressure

Rationale:
Decreasing the blood sugar by more than 50-100 per hour will cause changes in pressures in the fluid risking increased intracranial pressure. The client would be more likely to develop insulin shock with a swift decrease in blood glucose. Cardiac arrhythmias are not a complication of decreasing blood sugars nor is the risk of fluid deficit.

Answer to Question 2

3. It is important to maintain hope that a client can make positive change..

Rationale:
It is important to maintain hope and therapeutic optimism despite slow progress and setbacks, which are part of the recovery process. Even if a client is not currently making much effort toward management of addiction disorders, the development of a trusting relationship with the nurse helps to set the stage for movement toward recovery in the future. While it is true that nurses are legally obligated to provide care, this response is not client-focused and is therefore inappropriate.