A client with type 1 diabetes mellitus who is hyperglycemic: which problem should the nurse consider first when planning care?

A client with type 1 diabetes mellitus who is hyperglycemic: which problem should the nurse consider first when planning care?

• A. Insomnia
• B. Lack of appetite
• C. Signs of dehydration
• D. The need for knowledge about the diagnosis

Answer: (C)

When blood glucose is high in type 1 diabetes, the body loses a lot of water through the urine (osmotic diuresis). That makes dehydration the most immediate concern because it can compromise circulating volume, perfusion, and electrolyte balance, and it often accompanies or precedes more dangerous states like diabetic ketoacidosis. So, the first planning focus is assessing for dehydration and initiating fluid and electrolyte management, along with close monitoring of vitals, intake and output, and labs. Other issues like insomnia, appetite changes, or teaching needs are important, but they don’t pose the same immediate risk to stability.

When blood glucose is high in type 1 diabetes, the body loses a lot of water through the urine (osmotic diuresis). That makes dehydration the most immediate concern because it can compromise circulating volume, perfusion, and electrolyte balance, and it often accompanies or precedes more dangerous states like diabetic ketoacidosis. So, the first planning focus is assessing for dehydration and initiating fluid and electrolyte management, along with close monitoring of vitals, intake and output, and labs. Other issues like insomnia, appetite changes, or teaching needs are important, but they don’t pose the same immediate risk to stability.