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43 Cards in this Set
- Front
- Back
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Which symptom is indicative of hypoglycemia?
a. irritability b. drowsiness c. abdominal pain d. N & V |
A. Irritability: signs of hypoglycemia include irritability, shaky feeling, hunger, headache, dizziness.
Drowsiness, abdominal pain, nausea, and vomiting are signs of HYPERglycemia. |
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A nurse should understand that hyperglycemia associated with diaabetic ketoacidosis is defined as a blood glucose measurement equal to or greater than?
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300 mg / dl
DKA determined by BG of 300 or greater. Accompanied by acdetone breath, dehydration, weak and rapid pulse, and decreased level of consciousness. |
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A nurse shoud recognize which symptom as a cardinal sign of diabetes mellitus?
a. Nausea b. Seizure c. Hyperactivity d. Frequent urination |
D. Frequent Urination
Polyphagia, polyuria, polydipsia, and weight loss are cardinal signs of DM. Other signs include irritability, shortened attention span, lowered frustration tolerance, fatigue, dry skin, blurred vision, sores that are slow to heal, and flushed skin. |
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Why is blood glucose monitoring needed?
a. easier method of testing b. less expensive c. better management of diabetes d. greater sense of control over diabetes |
C. Better management.
BG monitoring improves diabetes management and is used successfully from the onset of their diabetes. By testing your own blood, you are able to change insulin regimen to maintain their glucose level in the normoglycemic range of 80 - 120 mg / dl. This allows better management of their diabetes. |
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A client is learning to mix regular insulin and NPH insulin in the same syringe. Which action, if performed by the client, would indicate the need for FURTHER teaching?
a. Withdrawing the NPH insulin first b. Injecting air into the NPH insulin bottle first c. After drawing up first insulin, removing air bubbles d. Injecting an amt of air equal to the desired dose of insulin |
a. Withdrawing NPH insulin first.
Regular insulin is ALWAYS withdrawn first so it won't become contaminated with NPH insulin. The client is instructed to inject air into the NPH insulin bottle equal to the amt of insulin to be withdrawn because there will be regular insulin in the syringe and he won't be able to inject air when he needs to withdraw the NPH. It's necessary to remove the air bubbles to ensure a correct dosage before drawing u p the second insulin. |
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A client is diagnosed with diabetes type 1. The primary health care provider prescribes an insulin regimen of regular insluin and NPH insulin administered subcutaneously each morning. How soon after administration will the onset of regular insulin begin?
a. within 5 minutes b. 1/2 hr to 1 hr c. 1 - 1 1/2 hrs d. 4-8 hrs |
b. 1/2 hour to 1 hour
Regular insulin's onset is 1/2 to 1 hr. peak is 2-4 hours, and duration is 3-6 hours. Lispro insulin has an onset within 5 minutes NPH has onset within 2-4 hrs Ultralente insulin is the longest acting with an onset of 6-10 hrs |
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A client who is started on metformin and glyburide would have initially presented with which symptoms?
a. Polydispisa, polyuria, and weight loss b. weight gain, tiredness, & bradycardia c. irritability, diaphoresis, and tachycardia d. diarrhea, abdominal pain, and weight loss |
a. Polydispisa, polyuria, and weight loss
Symptoms of hyperglycemia include polydipsia, polyuria, and weight loss. Metformin and sulfonylureas are commonly ordered medications. Weight gain, tiredness, and bradycardia are symptoms of hypothyroidism. Irritability, diaphoresis, and tachycardia are symptoms of hypoglycemia. Symptoms of Crohn's disease include diarrhea, abdominal pain, and weight loss. |
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A client presents with diaphoresis, palpitations, jitters, and tachycardia approx 1.5 hrs after taking his reg morning insulin. Which treatment is appropriate for this client?
a. check blood glucose level and administer carbohydrates. b. give nitroglycerin and perform an ECG c. check pulse oximetery and administer O2 therapy d. Restrict salt, administer diuretics and perform a paracentesis. |
a. check blood glucose level and administer carbohydrates
The client is experiencing symptoms of hypoglycemia. Checking the blood glucose level and administering carbs will elevate blood glucose. ECG and nitroglycerin are treatments for MI O2 won't correct lovw blood glucose level. Restricting salt, admin diuretics, and performing paracentesis are tx for ascites. |
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Which nursing consideration must be taken into account for a client with type 1 diabetes mellitus on the morning of surgery?
a. take on-half of usual daily dose of intermediate acting insulin b. receive an oral antidiabetic agent receive an IV insulin infusion take his full daily insulin dose with no dextrose infusion |
a. take on-half of usual daily dose of intermediate acting insulin
If the client takes his full daily dose of intermediate-acting insulin when he isn't allowed anything orally before surgery, he'll become hypoglycemic. On-half the insulin dose will provide all that is needed. Clients with type 1 don't take oral anti-iabetic agents IV insulin infusions aren't standard for routine surgery; used in the management of clients undergoing stressful procedures - such as transplants or coronary artery bypass surgery |
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Which type of diabetes is controlled primarily through diet, exercise, and oral antidiabetic agents?
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Diabetes Mellitus type II
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Which nursing intervention should be taken for a client who complains of N & V 1 hour after taking his morning glyburide?
a. give glyburide again b. give subQ insulin and monitor BG c. Monitor blood glucose closely, and look for signs of hypoglycemia d. monitor BG and assess for symptoms of hyperglycemia |
c. Monitor blood glucose closely, and look for signs of hypoglycemia
When a client who has taken an oral antidiabetic agent vomits, the nurse should monitor glucose and assess him frequently for signs of hypoglycemia. Most of the medication has probably been absorbed. Therefore, repeating the dose would further lower glucose levels later in the day. giving insulin also will lower glucose levels, causing hypoglycemia client wouldn't have hyperglycemia if they glyburide was absorbed. |
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When teaching a newly diagnosed diabetic dclient about diet and exercise, it's important to include which directive?
a. use of fiber laxatives and bulk-forming agents b. management of fluid, protein, and electrolytes c. reduction of calorie intake before exercising d. caloric goals, food consistency, and physical activity |
d. caloric goals, food consistency, and physical activity
Diabetic clients must be taught the relationship among caloric goals, consistency of food composition, and physical activity. Fiber lax and bluk forming agents are treatments for constipation management of fluids, proteins, and electorlytes is important for client wit hacute renal failure diabetic client may need to intake additional calories before exercising |
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Nurse is teaching a client with DM about chronic complications associated with the disease. Which info should she include in her teaching?
a. buy shoes that are a half size larger b. annual eye exams are recommended c. excessive exercise increases insulin resistance d. podiatry visits are necessary every 5 years |
b. annual eye exams are recommended
Retinopathy is a chronic complication of DM. Therefore yearly eye exams are recommended. Because of the risk of serious foot injuries, shoes should fit properly and be the correct size. Exercise decreases insulin resistance A podiatrist should be seen on a yearly basis |
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Rotating injection sites when administering insulin prevents which complication?
a. insulin edema b. insulin lipodystrophy c. insulin resistance d. systemic allergic reactions |
b. insulin lipodystrophy
Insulin lipodystrophy produces fatty masses at the injection sites, causing unpredictable absorption of insulin injected into those sites. Insulin edema is generalized retention of fluid, sometimes seen after normal blood glucose levels are established in a client with prolonged hypergylecemia Insulin resistance occurs mostly in overweight clients and is due to insulin binding with antibodies, decreasing the amt of absorption. systemic allergic reactions range from hives to anaphylaxis; rotating injection sites won't prevent these. |
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Which test allows a RAPID measurement of glucose in whole blood?
a. Capillary blood glucose test b. serum keton test c. serum T4 test d. urine glucose test |
a. Capillary blood glucose test
This test is a rapid test used to show BG levels. ketone test is used to document diabetic ketoacidosis by titration and may allow determination of serum ketone concentration a serum T4 test is used to diagnosis thyroid disorders. Most of the time, however neither serum ketone levesls nor T4 levels are useful in determining BG levels urine glucose test monitors glucose levels in urine and is influenced by both glucose and water excretion. Therefore, results correlate poorly with BG levels |
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How long does the peak effect last for Novolin NPH, an intermediat-acting insulin?
a. 15 min - 1 hr b. 2-6 hrs c. 6-16 hrs d. 14-26 hrs |
c. 6-16 hrs
Novolin NPH has a peak effect of 6-16 hrs. the peak effect of rapid-acting insulin is 2-6 hrs long -acting insulin has a peak effect of 14-26 hrs onset of rapid acting insulin is 15 min - 1 hr |
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The polydipsia and polyuria related to diabetes mellitus are primarily caused by
A. the release of ketones from cells during fat metabolism. B. fluid shifts resulting from the osmotic effect of hyperglycemia. C. damage to the kidneys from exposure to high levels of glucose. D. changes in RBCs resulting from attachment of excessive glucose to hemoglobin. |
B. fluid shifts resulting from the osmotic effect of hyperglycemia.
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When a patient with type 2 diabetes mellitus is admitted to the hospital with pneumonia, the nurse recognizes that the patient
A. must receive insulin therapy to prevent the development of ketoacidosis. B. has islet cell antibodies that have destroyed the ability of the pancreas to produce insulin. C. has minimal or absent endogenous insulin secretion and requires daily insulin injections. D. may have sufficient endogenous insulin to prevent ketosis but is at risk for development of hyperosmolar hyperglycemic nonketotic syndrome. |
D. may have sufficient endogenous insulin to prevent ketosis but is at risk for development of hyperosmolar hyperglycemic nonketotic syndrome.
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Effective collaborative management of diabetes includes
A. using insulin with all patients to achieve glycemic goals. B. relying on the health care provider as the central figure in the program for good control. C. relying solely on nutritional therapy as the initial treatment modality for all patients with diabetes. D. aiming for a balance of diet, activity, and medications together with appropriate monitoring and patient and family teaching. |
D. aiming for a balance of diet, activity, and medications together with appropriate monitoring and patient and family teaching.
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The nurse assists the patient with nutritional therapy of diabetes with the knowledge that a “diabetic diet” is designed
A. to be used only for type 1 diabetes. B. for use during periods of high stress. C. to normalize blood glucose by elimination of sugar. D. to help normalize blood glucose through a balanced diet. |
D. to help normalize blood glucose through a balanced diet.
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In teaching a newly diagnosed type 1 diabetic “survival skills,” the nurse includes information about
A. weight loss measures. B. elimination of sugar from diet. C. need to reduce physical activity. D. self-monitoring of blood glucose. |
D. self-monitoring of blood glucose.
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An appropriate teaching measure for the patient with diabetes mellitus related to care of the feet is to
A. use heat to increase blood supply. B. avoid softening lotions and creams. C. inspect all surfaces of the feet daily. D. use iodine to disinfect cuts and abrasions. |
C. inspect all surfaces of the feet daily.
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A diabetic patient has a serum glucose level of 824 mg/dl (45.7 mmol/L) and is unresponsive. Following assessment of the patient, the nurse suspects diabetic ketoacidosis rather than hyperosmolar hyperglycemic nonketotic syndrome based on the finding of
A. polyuria. B. severe dehydration. C. rapid, deep respirations. D. decreased serum potassium. |
C. rapid, deep respirations.
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Although the primary function of insulin is to promote glucose transport from the blood into the cell, insulin also:
a. enhances breakdown of adipose tissue for energy b. stimulates hepatic glycogenolysis and gluconeogenosis c. prevents transport of tryglycerides into adipose tissue d. accelerates the transport of amino acids into cells and their synthesis into protein |
d. accelerates the transport of amino acids into cells and their synthesis into protein
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Tissues that require insulin for glucose transport are:
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adipose & skeletal muscle
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During developement of type 1 diabetes, the beta cell response to the hyperglycemia can be identified in the blood and urine by the presence of:
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Proinsulin C-peptides
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Two hormones released during physical and emotional stress that are conterregulatroy to insulin are:
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Cortisol & Epinephrine
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The type of diabetes that is strongly related to human leukocyte antigen type is:
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Type 1
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Type 1 or 2?
Inherited defect in insulin receptors: |
Type 2
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Type 1 or 2?
Production of islet cell antibodies |
Type 1
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Typer 1 or 2?
Genetic susceptibility for antibody production? |
Type 1
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Type 1 or 2?
Inappropriate glucose production by the liver |
Type 2
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Type 1 or 2?
Beta Cell destruction |
Type 1
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Describe process occurring with
POLYURIA |
High glucose levels cause loss of glucose in urine with osmotic diuresis
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Describe process occurring with
POLYDYPSIA |
Thirst caused by fluid loss of polyuria
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Describe process occuring with
POLYPHAGIA |
Cellular starvation from lack of glucose and use of fat and protein for energy
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The nurse identifies that the risk for developing diabetes is highes in:
a. 62 yr old obese white man b. obese, 50 yr old hispanic woman c. child whose father has type 1 diabetes d. 34 yr old woman whose parents both have type 2 diabetes |
d. 34 yr old woman whose parents both have type 2 diabetes
Type 2 diabetes has STRONG influence, 15%-45% of dvlpt. Type 1 genetic susceptibility is only 6-9%. Is more related to HLA Lower risks include the obesity / age / and race of the other answers |
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When caring for a patient with insulin resistance syndrome, the nurse plans teaching to decrease the patients risk for:
a. hypertension b. hypoglycemia c. cardiovascular disease d. hyperglycemic hyperosmolor nonketosis |
c. cardiovascular disease
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52 yr old patient admitted to hospital with vomiting and diarrhea has a fasting BS of 512 and pH 7.38. Diagnosed with diabetes M and treated with insulin and IV. The ruse recognizes that it is most likely that this patient:
a. will require insulin treatment only during stress b. is demonstrating abrupt onset of type 1 diabetes c. will require long-term insulin therapy to control diabetes d. has enough endogenous insulin to prevent diabetic ketoacidosis with the hyperglycemia |
d. has enough endogenous insulin to prevent diabetic ketoacidosis with the hyperglycemia
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during a routine health screening a patient has a fasting plasma Glucose of 132. AT following visit diabetes would be diagnoses based on:
a. glucosuria of 3+ b. FPG of 126 c. random plasma glucose of 210 d. OGTT of 190 |
c. random plasma glucose of 210
On at least two testings, diabetes is diagnosed with a random plasma glucose over 200 a fasting plasma glucose over 126 or a OGTT over 200 fasting plasma glucose testing preferred |
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Nurse determines that a patient with a 2-hour OGTT of 152 has:
a. diabetes b. impaired fasting glucose c. impaired glucose tolerance d. elevated glycosolated hemoglobin |
c. impaired glucose tolerance
Between 140 - 200 is "Pre-diabetes" OVer 200 = dx of diabetes |
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When teaching patient about isulin administration, the nurse instructs the patient to:
a. pull back on plunger to check for blood b. clean the skin at inj. site c. consistently use the same size of the appropriate strength insulin syringe to avoid dosing errors d. rotate inj. site from arms to thighs to abdomen |
c. consistently use the same size of the appropriate strength insulin syringe to avoid dosing errors
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A patient with type 1 diabetes uses 20U of 70/30 (NPH/regular) in the morning and at 6 pm. The nurse stresses what about meal plans?
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A set meal pattern with a bedtime snack is necessary to prevent hypoglycemia
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