A nurse is caring for a client with type I diabetes mellitus. Because the client is at risk for hypoglycaemia, which of the following does the nurse teach the client?

Appeared in: UPUMS Nsg.Officer-2024

Explanation

This option provides a comprehensive safety plan for managing hypoglycemia, addressing both mild/moderate and severe episodes.
Glucose tablets are a form of fast-acting carbohydrate used to treat conscious hypoglycemia, often following the 'Rule of 15'.
Subcutaneous glucagon is an emergency rescue medication for severe hypoglycemia when the patient is unconscious or unable to swallow.
Teaching the patient to have both available empowers them and their family to respond appropriately to any level of hypoglycemic event, preventing severe complications.

Option A: Discontinuing insulin without medical advice is extremely dangerous and can lead to hyperglycemia and diabetic ketoacidosis (DKA).
Option B: Monitoring for acetone (ketones) in the urine is indicated for hyperglycemia, not hypoglycemia. Ketones appear when the body burns fat for energy due to a lack of insulin.
Option C: Coma and drowsiness are late, life-threatening signs of severe hypoglycemia. Patient education should focus on recognizing and treating early warning signs (e.g., shakiness, sweating, anxiety) to prevent progression to this stage.

Clinical Relevance

Nursing practice connection: Use the key finding related to Patient Education for Hypoglycemia Management in Type 1 Diabetes to guide bedside assessment, documentation, and the next nursing action.
Hypoglycemia is a medical emergency in patients with diabetes, and if left untreated, it can rapidly lead to seizures, loss of consciousness, irreversible brain damage, and death.
Empowering patients and their families with the knowledge and tools to manage hypoglycemia is a critical nursing responsibility that directly impacts patient safety.
What if? The patient is found unconscious and a glucagon kit is not available? The correct action is to call for emergency medical services immediately (e.g., 108 in India). Do not attempt to give food or fluids by mouth, as this poses a high risk of aspiration.

How to Approach the Question

Identify the core concept of the question: patient teaching for a specific risk, which is hypoglycemia in a client with Type 1 Diabetes.
Analyze the options based on safety and accuracy for managing hypoglycemia.
Eliminate the option related to hyperglycemia (monitoring for acetone).
Eliminate the option that represents unsafe advice (discontinuing insulin).
Compare the remaining options. Recognizing late signs (coma) is less important for preventative teaching than being prepared to treat the condition at any stage.
Select the option that provides the most comprehensive and proactive plan for managing both mild and severe hypoglycemic episodes, which is a key safety principle in diabetes care.

Concept Tested & Keywords

Concept Tested: Patient Education for Hypoglycemia Management in Type 1 Diabetes
Stem keywords: type I diabetes mellitus, hypoglycaemia, nurse teach
Lead-in keywords: which of the following
Clinical cues: Client with Type 1 Diabetes Mellitus, indicating insulin dependence and a higher risk of hypoglycemia.

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E6 Pharmacology Nursing Lilley 11e Part 2 pp. 217-219, 214-216

E6 Nursing Vital Signs p. 204-206

Practise the full UPUMS Nsg.Officer-2024

Attempt every question from this paper in a timed mock, then review the full solution for each one.