Mr. P is a newly diagnosed diabetic client in for his first visit ...

[abern]

Mr. P is a newly diagnosed diabetic client in for his first visit with the nurse educator. His biggest complaint is frequent urination that interferes with his job and his sleep. The best response the nurse can make is that:
 
  1. Once your blood sugar is less than 200 you won't be as thirsty and so won't urinate as frequently..
   2. Without enough insulin, glucose is not absorbed into the cells but is excreted by the kidneys along with large amounts of water causing frequent urination..
   3. Frequent urination is a common event with diabetes and should be expected to continue regardless of how well your blood sugar is controlled..
   4. Limiting the amount of fluids in the evening may help to decrease the number of times you wake up during the night to urinate..

Question 2

A 79-year-old client has been admitted to a long-term care facility that follows a liberal diet approach. The family is concerned that this will hurt the client due to a long history of high cholesterol and desire a low-cholesterol diet.
 
  How might the nurse respond? A) Malnutrition is a greater threat than hypercholesterolemi a.
  B) The client is too old to worry about it now.
  C) The facility does not offer specialized, individual diet options.
  D) If the cholesterol hasn't gone down yet, it never will.

[Ahernandez18]

Answer to Question 1

2
Rationale: Blood sugars of 200 or more are an indicator of poor glucose control and considered hyperglycemic, causing symptoms of polyuria, polydipsia, and polyphagia. High amounts of glucose without sufficient insulin from endogenous or chemical sources result in excessive glucose circulating in the blood without being absorbed into cells which the kidneys to eliminate along with large amounts of water resulting in frequent urination. Polyuria is a symptom of hyperglycemia and does not occur when there is a balance between glucose intake and insulin availability. Limiting the amount of fluids consumed in the evening will usually help to decrease nocturia in the absence of pathology.

Answer to Question 2

A
Feedback:
The nurse should always show respect to the family. It should be explained to the family that the relationship between high cholesterol and all-cause mortality in older adults is under debate. Because malnutrition is a greater threat, this should be the focus.