A 68-year-old female client with advanced chronic kidney disease (CKD) stage 4, peripheral neuropathy, and type 2 diabetes presents to the clinic for a follow-up. She is currently on insulin therapy and her A1C is 8.5%. The healthcare provider knows:
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✓ Correct answer: C. The client's A1C level is currently at goalAnswer: This client's A1C level is currently at goal. The goals of glucose control should be individualized based on the client's overall health status, particularly the presence of comorbidities, cognitive function, and ability to perform day-to-day activities. In clients with significant comorbidities such as advanced CKD, an A1C goal of > 8% might be appropriate to avoid hypoglycemia and other complications. This client fits those criteria making her current A1C of 8.5% acceptable. In the absence of significant comorbidities or functional decline, the A1C target may be more stringent (e.g., < 7%), but in clients with conditions like CKD, looser targets are often justified.
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