Page 1423 - Saunders Comprehensive Review For NCLEX-RN

▪ Provide meticulous skin care and proper foot care.

▪ Inspect feet daily and monitor feet for redness, swelling, or break in skin
integrity.
▪ Notify the primary health care provider if redness or a break in the skin occurs.

▪ Avoid thermal injuries from hot water, heating pads, and baths.
▪ Wash feet with warm (not hot) water and dry thoroughly (avoid foot soaks).
▪ Avoid treating corns, blisters, or ingrown toenails.
▪ Do not cross legs or wear tight garments that may constrict blood flow.
▪ Apply moisturizing lotion to the feet but not between the toes.
▪ Prevent moisture from accumulating between the toes.
▪ Wear loose socks and well-fitting (not tight) shoes; do not go barefoot.
▪ Wear clean cotton socks to keep the feet warm and change the socks daily.
▪ Avoid wearing the same pair of shoes 2 days in a row.
▪ Avoid wearing open-toed shoes or shoes with a strap that goes between the toes.
▪ Check shoes for cracks or tears in the lining and for foreign objects before
putting them on.
▪ Break in new shoes gradually.
▪ Cut toenails straight across and smooth nails with an emery board.

▪ Avoid smoking.
▪ Follow-up with podiatry referral and recommendations as needed.

Practice Questions

487. A client is brought to the emergency department in an unresponsive state,
and a diagnosis of hyperosmolar hyperglycemic syndrome is made. The
nurse would immediately prepare to initiate which anticipated primary
health care provider’s prescription?
1. Endotracheal intubation
2. 100 units of NPH insulin
3. Intravenous infusion of normal saline
4. Intravenous infusion of sodium bicarbonate
488. An external insulin pump is prescribed for a client with diabetes mellitus.
When the client asks the nurse about the functioning of the pump, the nurse
bases the response on which information about the pump?
1. It is timed to release programmed doses of either short-duration
or NPH insulin into the bloodstream at specific intervals.
2. It continuously infuses small amounts of NPH insulin into the
bloodstream while regularly monitoring blood glucose levels.
3. It is surgically attached to the pancreas and infuses regular insulin
into the pancreas. This releases insulin into the bloodstream.
4. It administers a small continuous dose of short-duration insulin
subcutaneously. The client can self-administer an additional bolus
dose from the pump before each meal.
489. A client with a diagnosis of diabetic ketoacidosis (DKA) is being treated in

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