# A nurse is teaching a client with type 1 diabetes about sick-day management. Which instructions should the nurse include? For each group, select all responses that apply.

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> url: https://mymerci.kr/pages/nclex_q.php?qn_id=620059&lang=en  
> language: en  
> subject: Health Screening  
> category: HPM

## Question

A nurse is teaching a client with type 1 diabetes about sick-day management. Which instructions should the nurse include? For each group, select all responses that apply.

Monitoring and medication

Check blood glucose and urine ketones every 4 hours.

Stop taking insulin if unable to eat.

Continue taking insulin as prescribed.

Take extra oral hypoglycemic agents to lower high glucose.

Fluid and nutrition

Drink 8 ounces of sugar-free fluids every hour while awake.

Consume 15 grams of carbohydrate every 1-2 hours if unable to eat meals.

Avoid all fluids if vomiting to rest the stomach.

Eat high-fat foods to maintain calorie intake.

## Explanation

During illness, clients with type 1 diabetes should check blood glucose and urine ketones every 4 hours. Insulin should never be stopped; doses may need adjustment. Oral hypoglycemics are not used in type 1 diabetes. Fluids are important; drink sugar-free fluids every hour if awake. If unable to eat, consume 15 grams of carbohydrate every 1-2 hours. Vomiting does not mean avoiding fluids; small sips are encouraged. High-fat foods are not recommended.

## In-depth explanation

Quick answer
During illness, clients with type 1 diabetes should check blood glucose and urine ketones every 4 hours. Insulin should never be stopped; doses may need adjustment. Oral hypoglycemics are not used in type 1 diabetes. Fluids are important; drink sugar-free fluids every hour if awake. If unable to eat, consume 15 grams of carbohydrate every 1-2 hours. Vomiting does not mean avoiding fluids; small sips are encouraged. High-fat foods are not recommended.
Key cues
Use the client-specific assessment findings and timing in the scenario rather than a memorized diagnosis label.
Clinical reasoning
Connect the relevant cues to the safest nursing interpretation and action for this exact care setting.
Why the alternatives do not fit
The distractors are plausible in another context but are unsupported, mistimed, lower priority, or incomplete for the findings presented.
Priority and safety
Address immediate threats first, stay within nursing scope, and reassess the client after the selected intervention.
Takeaway
For diabetes sick-day management, select responses that are both clinically supported and appropriate at this point in care.
**Sources**
- CDC Low Blood Sugar Treatment

## Clinical scenario

A nurse is teaching a client with type 1 diabetes about sick-day management. Which instructions should the nurse include? For each group, select all responses that apply.

## Key concepts

- **Ketones** — Byproducts of fat breakdown; indicate insulin deficiency.
- **Sick-day rules** — Guidelines for managing diabetes during illness.
- **Type 1 diabetes** — Autoimmune destruction of beta cells; requires insulin.

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