Special Considerations in Patient Assessment and Documentation
Special Considerations in Patient Assessment and Documentation ( 6 Questions)
A nurse is reviewing the laboratory results of a client who has diabetes mellitus.
Which of the following values should the nurse report to the provider as a priority?
Hemoglobin A1c is a measure of the average blood glucose level over the past 2 to 3 months. A value of 8.5% indicates poor glycemic control and an increased risk of complications, but it is not an emergency.
Blood glucose is a measure of the amount of glucose in the blood at a given time. A value of 180 mg/dL indicates hyperglycemia, which is common in clients who have diabetes mellitus, but it is not an emergency.
Urine ketones 3+ indicate a high level of ketones in the urine, which is a sign of diabetic ketoacidosis (DKA), a life-threatening complication of diabetes mellitus. DKA occurs when the body breaks down fat for energy due to insufficient insulin, resulting in the production of acidic ketones that cause metabolic acidosis. The nurse should report this value to the provider as a priority and prepare to administer intravenous fluids, insulin, and electrolytes as prescribed.
Serum creatinine is a measure of the amount of creatinine, a waste product of muscle metabolism, in the blood. A value of 1.2 mg/dL is within the normal range for adults and does not indicate any problem.
Urine ketones 3+
Rationale: Urine ketones 3+ indicate a high level of ketones in the urine, which is a sign of diabetic ketoacidosis (DKA), a life-threatening complication of diabetes mellitus. DKA occurs when the body breaks down fat for energy due to insufficient insulin, resulting in the production of acidic ketones that cause metabolic acidosis. The nurse should report this value to the provider as a priority and prepare to administer intravenous fluids, insulin, and electrolytes as prescribed.
Incorrect options:
A) Hemoglobin A1c 8.5% - Hemoglobin A1c is a measure of the average blood glucose level over the past 2 to 3 months. A value of 8.5% indicates poor glycemic control and an increased risk of complications, but it is not an emergency.
B) Blood glucose 180 mg/dL - Blood glucose is a measure of the amount of glucose in the blood at a given time. A value of 180 mg/dL indicates hyperglycemia, which is common in clients who have diabetes mellitus, but it is not an emergency.
D) Serum creatinine 1.2 mg/dL - Serum creatinine is a measure of the amount of creatinine, a waste product of muscle metabolism, in the blood. A value of 1.2 mg/dL is within the normal range for adults and does not indicate any problem.