A nurse is contributing to the plan of care for a client who has a new diagnosis of type 2 diabetes mellitus. Which of the following interventions should the nurse include? (Select all that apply.)
Explanation & Rationale
A. Instruct the client to soak his feet daily. Soaking increases risk of skin breakdown and infection in clients with diabetes; daily inspection and gentle washing are advised instead. B. Give the client an extra dose of insulin for a blood glucose level of 50 mg/dL. A blood glucose of 50 mg/dL indicates hypoglycemia and should be treated with fast-acting carbohydrate (glucose tablets, juice), not additional insulin. C. Offer the client 240 mL (8 oz) of skim milk if the client's skin becomes cool and clammy. Cool, clammy skin suggests hypoglycemia; providing a carbohydrate source such as 8 oz of milk can raise blood glucose and is an acceptable treatment if faster simple carbs are not available. D. Assist the client to develop an individualized meal plan. Individualized meal planning supports glycemic control and fits with lifestyle, preferences, and medication regimens - this is a key self-management intervention. E. Check the client's blood glucose level before meals and bedtime. Routine monitoring before meals and at bedtime helps detect hyper- and hypoglycemia and guides meal/medication adjustments.