A patient who has recently been diagnosed with type 1 diabetes ...

[newbem]

A patient who has recently been diagnosed with type 1 diabetes mellitus will require insulin therapy. The patient states, I guess I will have to give up the half bottle of wine I drink at dinner. Which information should the nurse provide?
 
  1. Wine is not permitted on your diet.
  2. You can drink as much wine as you would like but avoid hard liquor.
  3. Limit your wine to a time when you are eating a complete meal.
  4. Limit your wine to one glass a day.
  5. Milk is a better choice for you so substitute it for wine.

Question 2

The client is prescribed phenelzine (Nardil). The client tells the nurse that they consumed two glasses of Chianti wine at lunchtime. What is the nurse's priority action?
 
  1. Assess the client's blood pressure.
  2. Discuss the effects of wine on the action of antidepressants.
  3. Arrange for admittance to the psychiatric unit.
  4. Discuss how food can increase the symptoms of depression.

[bob]

Answer to Question 1

3,4
Rationale 1: Wine does not have to be eliminated from this patient's diet.
Rationale 2: The amount of wine permitted is not unlimited.
Rationale 3: Alcoholic beverages should be consumed along with a complete meal.
Rationale 4: Alcoholic beverages should be limited to one per day.
Rationale 5: Large amounts of milk would also interfere with the patient's glucose control.

Global Rationale: Alcoholic beverages should be consumed along with a complete meal and should be limited to one per day. Wine does not have to be eliminated from this patient's diet, but the amount of wine permitted is not unlimited. Large amounts of milk would also interfere with the patient's glucose control.

Answer to Question 2

1

Rationale 1: Assessing the client's blood pressure is appropriate because Chianti wine is high in dietary tyramine. This can result in a hypertensive crisis when combined with an MAOI drug. So the nurse must check the client's blood pressure. It is important to discuss the effects of alcohol and antidepressants, but physiological assessment takes priority over education.
Rationale 2: Discussing the effects of wine on the action of antidepressants is incorrect because while it is important to discuss the effects of alcohol and antidepressants, physiological assessment takes priority over education. Likewise, alcohol can increase the symptoms of depression, but physiological assessment takes priority over education.
Rationale 3: Arranging for admittance to the psychiatric unit is incorrect because admittance to the psychiatric unit is not appropriate at this time; there is no evidence that the client is suicidal.
Rationale 4: Discussing how food can increase the symptoms of depression is incorrect because while alcohol can increase the symptoms of depression, physiological assessment takes priority over education.

Global Rationale: Assessing the client's blood pressure is appropriate because Chianti wine is high in dietary tyramine. This can result in a hypertensive crisis when combined with an MAOI drug. So the nurse must check the client's blood pressure.

[newbem]

Excellent

[coreycathey]

Gracias!