Chapters 57-60 EAQ Endocrine

The patient has been prescribed lispro [Humalog] for treatment of type 1 diabetes mellitus. The nurse should give the patient which instruction?

"Inject this insulin with meals because it is very fast acting."

Which lifestyle changes should the nurse instruct a patient to implement in order to successfully manage diabetes mellitus? Select all that apply.

"Reduce the amount of alcohol you consume." "Incorporate daily physical exercise into your life." "Decrease the amount of carbohydrates in your diet."

A patient newly diagnosed with type 2 diabetes mellitus has been ordered insulin glargine [Lantus]. Which information is essential for the nurse to teach this patient?

"This medication has a duration of action of 24 hours."

Which patient instructions should the nurse provide for a pregnant woman with gestational diabetes?

"You must take insulin injections as prescribed."

A patient receives isophane suspension, also known as neutral protamine Hagedorn (NPH) insulin at 8:00 AM. The patient eats breakfast at 8:30 AM, lunch at noon, and dinner at 6:00 PM. At what time is this patient at the highest risk for hypoglycemia?

5:00pm

Which is the nurse's best action when finding a patient with type 1 diabetes mellitus unresponsive, cold, and clammy?

Administer intravenous glucose

Which laboratory test would give the most accurate evidence of a diabetic patient's treatment compliance and glucose management over the past few months?

Glycosylated hemoglobin (HbA1c)

Which technique is most appropriate regarding mixing insulin when a patient must administer 30 units regular insulin and 70 units neutral protamine Hagedorn (NPH) insulin in the morning?

Draw up the regular insulin into the syringe first, followed by the cloudy NPH insulin

Which hormones play a role in the regulation of glucose homeostasis? Select all that apply.

Insulin Glucagon

Which insulin should the nurse administer to supplement basal insulin to imitate the pancreatic surge of insulin that accompanies eating?

Insulin glulisine [Apidra]

A patient is scheduled to start taking insulin glargine [Lantus]. Which information should the nurse give the patient regarding this medication?

This medication provides blood glucose control for 24 hours.

A patient newly diagnosed with type 1 diabetes asks a nurse, "How does insulin normally work in my body?" The nurse should base his or her response on which understanding of the mechanism of insulin?

It promotes the passage of glucose into cells

Which assessment findings in a patient with diabetes mellitus are indicative of diabetic ketoacidosis? Select all that apply.

Ketones in the urine Isotonic dehydration Electrolyte imbalances Extreme hyperglycemia

Which are rapid-acting insulins that can be administered to patients with diabetes mellitus? Select all that apply.

Lispro [Humalog] Aspart [NovoLog] Glulisine [Apidra]

The nurse administers neutral protamine hagedorn (NPH) insulin at 8 AM. Which intervention is essential for the nurse to perform?

Make sure patient eats by 5 PM

The laboratory results for a diabetic patient indicate markedly elevated blood glucose levels. After assessing the patient, the nurse obtains a prescription for intravenous insulin therapy from the primary healthcare provider. Which other assessment finding is likely present in the patient's reports?

Presence of ketones in the serum

An operating room nurse prepares a patient who has type 2 diabetes for surgery. Which type of insulin should the nurse administer?

Regular insulin [Humulin R]

The nurse is teaching a patient who has type 1 diabetes mellitus how to prevent hypoglycemia. Which clinical indicators of hypoglycemia should the nurse identify for the patient and family? Select all that apply.

Sweating, headache, tachycardia.

Which early symptoms of hypoglycemia should the nurse instruct a patient's family to treat with a fast-acting carbohydrate source? Select all that apply.

Tremor Irritability Sweating Confusion

Which precautions should the nurse take before administering isophane insulin, also known as neutral protamine hagedorn (NPH) insulin suspension to a patient? Select all that apply.

Verify that insulin syringes are used. Rotate the injection locations every week. Monitor the patient's fasting serum glucose level.