9 Chapter 9
Answer Key to Chapter 9
You can review additional information regarding these answers in the corresponding section in which the Critical Thinking activities appear.
Critical Thinking Activity Section 9.3
- The client is at risk for a fracture due to a previous history of osteoporosis that weakens the bones and increases the risk for a fracture when injury occurs. Corticosteroids can cause muscle weakness that can lead to falls and fractures.
- Alendronate, a bisphosphonates class of medication, is often used to treat osteoporosis and reduce the client’s risk of fractures. Other preventative measures can be implemented such as weight-bearing exercise and calcium/vitamin D supplementation.
- The client should be instructed to avoid getting up without assistance. The room should be well-lit without loose rugs that can cause tripping. If the client uses assistive devices like a cane or walker, these devices should be readily available.
- The use of glucocorticoids can increase glucose levels. Although the client has no history of diabetes, the increased blood glucose levels may require the temporary use of insulin.
- Signs of adrenal suppression include severe fatigue, gastrointestinal upset, and a suppressed immune response that places the client at risk for developing infections.
Critical Thinking Activity Section 9.4
- Type 1 diabetes is an autoimmune disease affecting the beta cells of the pancreas so they do not produce insulin; synthetic insulin must be administered by injection or infusion.
Type 2 diabetes is acquired, and lifestyle factors such as poor diet and inactivity greatly increase a person’s risk for developing this disease. In type 2 diabetes, the body’s cells become resistant to the effects of insulin. In response, the pancreas increases its insulin secretion, but over time, the beta cells become exhausted. In many cases, type 2 diabetes can be reversed by moderate weight loss, regular physical activity, and consumption of a healthy diet. However, if blood glucose levels cannot be controlled with these measures, oral diabetic medication is implemented and eventually insulin may be required.
- Surgery and hospitalization often stimulate a client’s stress response, which includes the release of cortisol. Cortisol increases blood glucose levels, so the client may require insulin to control blood sugar levels while hospitalized.
- The nurse should administer 12 units of Humalog insulin, along with the scheduled 20 units of Humulin-N insulin at breakfast.
- Metformin may be discontinued because it is contraindicated in clients with kidney disease (e.g., serum creatinine levels ≥1.5 mg/dL [males] or ≥1.4 mg/dL [females]).
- The client is displaying signs of hypoglycemia. A supplementary carbohydrate, such as four ounces of orange juice, should be administered as soon as possible. However, if the client seems confused or unable to swallow, glucagon should be administered.
- The client has hypoglycemia because the peak effect of