Fundamentals of Nursing Q 283
A client is receiving nutrition via parenteral nutrition (PN). A nurse assesses the client for complications of the therapy and assesses the client for which of the following signs of hyperglycemia?
A. High-grade fever, chills, and decreased urination.
B. Fatigue, increased sweating, and heat intolerance.
C. Coarse dry hair, weakness, and fatigue.
D. Thirst, blurred vision, and diuresis.
Correct Answer: D. Thirst, blurred vision, and diuresis.
Signs of hyperglycemia include excessive thirst, fatigue, restlessness, blurred vision, confusion, weakness, Kussmaul’s respirations, diuresis, and coma when hyperglycemia is severe. Hyperglycaemia is found in up to 50% of PN patients. Important predictors are insulin resistance or diabetes mellitus, severity of the underlying illness, concomitant steroid therapy, and the amount of glucose provided.
Option A: High-grade fever, chills, and decreased urination are signs of infection. The risk of infectious complications is increased due to venous access for PN. The likelihood of hyperglycemia-induced complications may depend on concomitant diseases, duration of PN, and life expectancy.
Option B: Fatigue, increased sweating, and heat intolerance are signs of hyperthyroidism. Hyperthyroidism may manifest as weight loss despite an increased appetite, palpitation, nervousness, tremors, dyspnea, fatigability, diarrhea or increased GI motility, muscle weakness, heat intolerance, and diaphoresis.
Option C: Coarse dry hair, weakness, and fatigue are signs of hypothyroidism. Inquire about dry skin, voice changes, hair loss, constipation, fatigue, muscle cramps, cold intolerance, sleep disturbances, menstrual cycle abnormalities, weight gain, and galactorrhea. Also obtain a complete medical, surgical, medication, and family history.