A client with diabetes experiences hyperglycemia. Which problem should the nurse anticipate as a primary concern?

• A. Dehydration
• B. Lack of knowledge about nutrition
• C. Inability of family to cope with the client's diagnosis
• D. The need for knowledge about the causes of hyperglycemia

Answer: (A)

Osmotic diuresis from elevated blood glucose causes the kidneys to excrete glucose into the urine, and water follows this glucose into the urine. The result is large urine losses that lead to dehydration and intravascular volume depletion. This fluid deficit is the primary concern because it can quickly affect perfusion, heart rate, and overall stability. While education about nutrition, causes of hyperglycemia, and coping strategies are important for ongoing care, they don’t address the immediate physiologic issue created by hyperglycemia.