A client with hyperglycemic hyperosmolar state is discharged after treatment. The client says, 'I will call the doctor next time I can't eat for more than a day or so.' Which statement reflects the client's knowledge?

• A. The client needs immediate education before discharge.
• B. The client requires follow-up teaching regarding the administration of insulin.
• C. The client's statement is accurate, but knowledge should be evaluated further.
• D. The client's statement is inaccurate, and the client should be scheduled for outpatient diabetic counseling.

Answer: (A)

The key idea here is that discharge education must address urgent sick-day management after a life-threatening hyperglycemic crisis. Hyperglycemic hyperosmolar state can worsen quickly if intake is reduced or if dehydration persists, so patients need to understand that delaying care is dangerous and that certain situations require prompt evaluation rather than waiting to contact the doctor later.

Saying they’ll wait to call only if they can’t eat for more than a day shows a gap in recognizing the urgency of reduced intake and dehydration in HHNS. Immediate education is needed to teach what to do during illness or poor intake, including when to seek urgent care, how to manage fluids and food intake, and how to monitor glucose and symptoms. While further insulin teaching or outpatient counseling are important, they don’t address the immediate danger demonstrated by the patient’s statement.