Chat with AIExam 53: Integration
At a routine checkup,a 40-year-old female client who has had type 1 diabetes for 5 years has a blood pressure reading of 180/110;previous blood pressure readings have been within a range of 120/80 to 130/85.What nursing interventions would be appropriate for this client?
(91) 
VerifiedThe following are suggested guidelines for grading:
The nurse should retake the client's blood pressure several times to verify that the initial elevated reading is accurate,ask the client about experiencing any symptoms of elevated blood pressure,and then review any changes in the client's lifestyle,such as dietary compliance,exercise patterns,and presence of any psychological stressors.The nurse might consider obtaining a urine specimen to test for the presence of albumin,and if present,review pathophysiological changes of diabetes that affect the circulatory and renal systems with the client.
The nurse reviews the client's medical record listed below and would contact the physician regarding which of the following documented findings?
CLIENT'S CHART
Laboratory Test Result
Blood glucose,142 mg/dL
BUN,58 mg/dL
Serum creatinine,8 mg/dL
Client's History
Renal insufficiency,diabetes mellitus
Medication History
Folic acid (vitamin B?)orally daily
Glucophage orally twice a day
Diagnostic Test Result
Chest X-ray: normal
(87) VerifiedD
A 68-year-old female client notices the gradual development of muscular weakness,resting tremors in the upper extremities,and some muscular rigidity.Her health care provider makes a tentative diagnosis of Parkinson's disease and refers the client to a neurological specialist who confirms the diagnosis.What information could the nurse provide to the client and her family about the nature of Parkinson's disease? What are some of the things that the client and her family should prepare to cope with as the disease progresses? Describe key aspects of a teaching plan for the client and her family.
(73) VerifiedThe following are suggested guidelines for grading:
Parkinson's disease is a chronic,progressive,degenerative disease of unknown cause.The client and family should be prepared for increasing muscular rigidity and motor impairment in gait,facial expressions,and voice;fatigue;and increase in degree of tremors present.The client will eventually develop dysphagia,excessive sweating,hyperactivity of oil glands,constipation,orthostatic hypotension,and urinary incontinence due to autonomic dysfunction.While the client's intelligence is not affected,problems with judgment and emotional stability may occur.There is no cure for Parkinson's disease,and death results from complications of immobility and injury.
A teaching plan for this client would focus on maintaining functional ability:
1.Help the client and family understand the disease process and its consequences.
2.Maintain mobility as long as possible, which is possible with careful timing of prescribed anti-Parkinson medications such as Sinemet, Artane, Cogentin, and Pagitane. Other medications, such as antidepressants, may also be prescribed and are individualized to the client's symptoms.
3.Modify activities of daily living to promote independence in self-care as long as possible. Referral to physical and occupational therapy may be indicated. The client's home should be adapted as needed to promote safety and prevent injury. Adaptive devices such as a walker and devices to assist with self-feeding may be useful.
4.Recognize the need to modify the diet to provide ease of swallowing while maintaining weight. Encourage drinking plenty of fluids and eat high-fiber foods. Food may eventually need to be pureed.
5.Understand the medications prescribed and how to make adjustments in dosage based on symptoms.
6.Seek support for the client and family to cope with the stressors inherent with this diagnosis.
A 45-year-old female client who has a history of alcohol abuse develops severe jaundice and confusion;she also complains of nausea and indigestion.The client's blood pressure is elevated,both lower extremities are edematous,and the liver is enlarged.The client is admitted for treatment with a medical diagnosis of cirrhosis.What nursing diagnoses and interventions would be appropriate for this client?
(77) A nurse is caring for a client with cirrhosis.The nurse notes that the client is dyspneic,and crackles are heard on the auscultation of the lungs.The nurse suspects fluid volume excess secondary to congestive heart failure (CHF).What additional signs would the nurse expect to see if the cardiovascular system is being affected?
(77) A 60-year-old male client has just been diagnosed as having type 2 diabetes.The client is 30 pounds overweight and knows very little about his condition.What are the major points that the nurse should include in this client's teaching plan?
(87) The nurse is providing instruction to a client with diabetes mellitus regarding peritoneal dialysis.The nurse explains to the client that it is important to maintain the dwell time for the dialysis at the prescribed time.The nurse is aware that the rationale for this is because of the risk of:
(79) A 45-year-old male client with a history of hypertension for 5 years develops symptoms of congestive heart failure (CHF)and renal failure.What are some of the possible reasons the client has developed CHF and renal failure? Describe the areas in which nursing intervention with this client could have helped prevent development of these complications.
(75) A client has just been diagnosed as having type 2 diabetes.The client is a 60-year-old male who is 30 pounds overweight.He is married and has two grown children.What are several things the nurse who is assigned to this client needs to do before developing a plan of care for the client?
(76) A nurse is reviewing the health records of assigned clients.The nurse plans care knowing that which client is likely at risk for the development of third-spacing? (Select all that apply. )
(84) 
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