Medical Surgical Labs Diabetic Labs #5

Question

A 50-year-old woman presents with an A1C of 8.1%. Which action is most appropriate for this client?

Answers

  1. Begin client on sliding-scale insulin.
    • Rationale:

      This answer is not correct because it is the best action for a type 1 diabetic. A type 1 diabetic requires a revision in insulin if A1C rises above 6.5%. Diet and exercise are also important; however, in a type 1 diabetic, insulin is necessary.

  2. Prescribe an oral hypoglycemic.
    • Rationale:

      This answer is not correct because a change in diet and exercise should be initiated first. If blood glucose can be controlled by diet and exercise, this is better than starting medication.

  3. Begin a diet and exercise program.
    • Rationale:

      This answer is correct because there is no indication in the question that the client is already diabetic. The A1C indicates the client is experiencing hyperglycemia. For clients who are not diabetic or newly diagnosed, the initial treatment for diabetes is lifestyle changes in diet and exercise.

  4. Continue to monitor.
    • Rationale:

      This answer is not correct because the A1C is too high and needs to be addressed. Diet and exercise change should be initiated before medications.

Overview

Hemoglobin A1C should be between 6% and 6.5% for clients without diabetes. For a nondiabetic client with an A1C of 8.1%, initial treatment should be lifestyle changes starting with diet and exercise.

Explanation

Learning Outcomes

Hemoglobin A1C should be between 6% and 6.5% for clients without diabetes. Typically, diet and exercise is tried before initiation of insulin. This is true also for type 2 diabetics. It is important to weigh all factors that could potentially cause hyperglycemia. These include infections, steroids, and lifestyle habits. Only after initiation of change in lifestyle habits has been unsuccessful, should a client be started on insulin.

Test Taking Tip

Choose the less invasive treatment option first.

Video Rationale