A male client with type 1 diabetes mellitus has a highly elevated glycosylated hemoglobin (Hb) test result.
In discussing the result with the client, nurse Sharmaine would be most accurate in stating:
- A- “The test needs to be repeated following a 12-hour fast.”
- B- “It looks like you aren’t following the prescribed diabetic diet.”
- C- “It tells us about your sugar control for the last 3 months.”
- D- “Your insulin regimen needs to be altered significantly.”
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Answer C.
The glycosylated Hb test provides an objective measure of glycemic control over a 3-month period.
The test helps identify trends or practices that impair glycemic control, and it doesn’t require a fasting period before blood is drawn.
The nurse can’t conclude that the result occurs from poor dietary management or inadequate insulin coverage.
The most accurate statement nurse Sharmaine should make is: C- "It tells us about your sugar control for the last 3 months."
Here's why:
- A: While repeating the test under specific conditions can be valuable in some cases, a highly elevated HbA1c is already indicative of poor blood sugar control over a longer period.
- B: Although dietary adherence is crucial for diabetics, simply stating this without exploring further isn't the most accurate statement based on the HbA1c result alone.
- D: While adjusting the insulin regimen might be necessary, the HbA1c result doesn't directly translate to a significant shift without further examination of factors like current dosage and blood sugar fluctuations.
- C: HbA1c reflects the average blood sugar levels over the previous 2-3 months, making it the most accurate interpretation of the client's current condition based on the provided information.
Therefore, option C provides the most relevant and informative explanation of the client's HbA1c result.
Remember, while the other options might be part of the overall management plan, the HbA1c specifically points to long-term sugar control, not necessarily immediate dietary issues or an urgent need for significant insulin adjustments.
It's important for nurses like Sharmaine to communicate accurate and easily understandable information to their clients when discussing test results. Option C best achieves this by explaining the specific meaning of the elevated HbA1c in the context of the client's diabetes management.
