Diabetes Final
A client with diabetes mellitus asks the nurse to recommend something to remove corns from the toes. What should the nurse advise the client to do?
Consult a health care provider (HCP) about removing the corns.
The laboratory comes to draw an Hgb A1c. The client asks the nurse what this test represents. Which statement would be correct?
This test reflects the average blood glucose over a period of approximately 2-3 months."
The nurse is teaching the client about home blood glucose monitoring. Which blood glucose measurement indicates hypoglycemia?
59 mg/dL (3.3 mmol/L)
A client with diabetes is asking the nurse about drinking alcohol. The nurse's best response would be:
"Alcohol may decrease the normal physiologic reactions in the body that produce glucose. Therefore, there is a risk for hypoglycemia."
A nurse is teaching a client with type 1 diabetes how to treat adverse reactions to insulin. To reverse hypoglycemia, the client ideally should ingest an oral carbohydrate. However, this treatment isn't always possible or safe. Therefore, the nurse should advise the client to keep which alternate treatment on hand?
glucagon
A client tells the nurse that they have been working hard for the past 3 months to control the client's type 2 diabetes with diet and exercise. To determine the effectiveness of the client's efforts, the nurse should check
glycosylated hemoglobin level.
A client with diabetes who takes insulin has a blood glucose level of 40 mg/dL (2.27 mmol/L). What should the nurse offer the client to begin to raise the blood glucose level? Select all that apply.
one-half cup (120 mL) of orange juice one cup (240 mL) of milk one slice of bread one-half cup (120 mL) of regular soda
An agitated, confused client arrives in the emergency department. The client's history includes type 1 diabetes, hypertension, and angina pectoris. Assessment reveals pallor, diaphoresis, headache, and intense hunger. A stat blood glucose sample measures 42 mg/dl, (2.3 mmol/L) and the client is treated for an acute hypoglycemic reaction. After recovery, the nurse teaches the client to treat hypoglycemia by ingesting
15 g of a simple carbohydrate.
An obese client, age 65, is diagnosed with type 2 diabetes. When educating this client about the diagnosis, the nurse knows that more education is needed when the client says which statement? Select all that apply.
If I follow my diet and exercise, I won't have diabetes any more." "I can never eat a hot fudge sundae again." "I guess I will need to stop meeting my friends at the coffee shop."
A client's fasting blood sugar (FBS) is 63 mg/dL (3.5 mmol/L) at 0700. The client is alert and oriented. What should the nurse do first?
Give 15 g of carbohydrate and recheck the blood glucose in 15 minutes.
Your patients glucose is 65 what do you do?
IF RESPONSIVE: administer 15g of carbohydrates 4oz juice 4 glucose tablets 8oz milk 1 slice of bread recheck sugar q15 mins after treatment repeat until BG >70 If NPO administer 1/2 amp D50 or 1 mg of glucagon IF UNRESPONSIVE: call code blue glucose <70 1 amp D50 IV 1 mg glucagon
When obtaining a health history from a client newly admitted to the hospital, which statement indicates the client's needs for further follow-up?
No matter how much I drink, I'm still thirsty all the time."
A client with type 2 diabetes mellitus needs instruction on proper foot care. Which instructions should the nurse include in client teaching? Select all that apply.
Wear cotton socks. Apply foot powder after bathing. See a podiatrist regularly to have your feet checked.
Which combination of adverse effects should a nurse monitor for when administering I.V. insulin to a client with diabetic ketoacidosis?
hypokalemia and hypoglycemia
A client with diabetes mellitus is admitted with hypoglycemia. Which information should the nurse include in the client teaching? Select all that apply.
"Hypoglycemia can result from excessive alcohol consumption." "Skipping meals can cause hypoglycemia." "Strenuous activity may result in hypoglycemia." "Symptoms of hypoglycemia include shakiness, confusion, and headache."
The nurse is teaching a client with type I diabetes self-administration of insulin. Which statement by the client would be an expected outcome of the teaching session? Select all that apply.
1. "I need to make sure that I eat my meals and snacks on time after I take my insulin." 2. "If I monitor and control my blood glucose levels carefully, there is less likelihood of suffering long-term complications." 3. "If I exercise more than is normal, there is a risk that I might become hypoglycemic."
A client with type 1 diabetes presents with a decreased level of consciousness and a fingerstick glucose level of 39 mg/dl (2.2 mmol/L). His family reports that he has been skipping meals in an effort to lose weight. Which nursing intervention is most appropriate?
Administering 1 ampule of 50% dextrose solution, per physician's order
The nurse reviewed laboratory values for a client with type 1 diabetes mellitus. The client's hemoglobin A1c (HbA1c) is 9 percent. What is the priority action for the nurse?
Assess the client's baseline knowledge about their treatment regimen
When teaching the diabetic client about foot care, what should the nurse instruct the client to do?
Avoid going barefoot.
most common lab test to diagnose diabetes and why
HbA1C: tells glucose for the past 3 months. Most commonly used FBG: fasting blood glucose OGTT: two hour plasma glucose
A client with diabetes is explaining to the nurse how he cares for the feet at home. Which statement indicates the client needs further instruction on how to care for the feet properly?
I inspect my feet once a week for cuts and redness."
A client is going to receive an insulin pump prior to discharge and the nurse has done extensive teaching. Which statement indicates that the client has a good understanding about the pump?
I will need to monitor blood glucose levels multiple times a day while on the insulin pump."
A client with type 1 diabetes is admitted to an acute care facility with diabetic ketoacidosis. To correct this acute diabetic emergency, which measure should the healthcare team take first?
Initiate fluid replacement therapy.
for both unresponsive and responsive hypoglycemia you will...
Recheck glucose q15 mins and repeat until glucose greater than 70 or asymptomatic once glucose is greater than 70 check BG q1h for 2 hours notify provider if treatment requires more than 2 cycles notify if D50 or glucagon given to obtain order For glucose <50 obtain STAT serum BG and order
A nurse is caring for a client with type 1 diabetes who exhibits confusion, light-headedness, and aberrant behavior. The client is conscious. The nurse should first administer
15 to 20 g of a fast-acting carbohydrate such as orange juice.
When referred to a podiatrist, a client newly diagnosed with diabetes mellitus asks, "Why do you need to check my feet when I'm having a problem with my blood sugar?" The nurse's most helpful response to this statement is
Diabetes can affect sensation in your feet and you can hurt yourself without realizing it."
A client with type 1 diabetes mellitus has influenza. What should the nurse instruct the client to do?
Increase the frequency of blood glucose self-monitoring.
A client who has been diagnosed with type 1 diabetes has an insulin drip to aid in lowering the serum blood glucose level of 600 mg/dL (33.3 mmol/L). The client is also receiving ciprofloxacin IV. The health care provider (HCP) prescribes discontinuation of the insulin drip. What should the nurse do next?
Inform the HCP that the client has not received any subcutaneous insulin yet.
A client with diabetes is being tested for glycosylated hemoglobin. How would the nurse explain the reason for this diagnostic test?
It determines the average blood glucose level in the previous 2-3 months.
A client with type 1 diabetes has a highly elevated glycosylated hemoglobin (Hb) test result. In discussing the result with the client, the nurse is most accurate in stating
It tells us about your sugar control for the last 3 months."
A client with diabetes is explaining to the nurse how to care for the feet at home. Which statement indicates that the client understands proper foot care?
It's important to dry my feet carefully after my bath."
Which information should the nurse include about hypoglycemia when teaching a client newly diagnosed with type 2 diabetes mellitus? Select all that apply.
Regular meals and a bedtime snack will decrease the incidence of hypoglycemia. Symptoms of hypoglycemia can include irritability, hunger, shaking, and sweating. A carbohydrate food source should be available during strenuous exercise. Alcohol consumption can increase the incidence of hypoglycemia.
A client with diabetes mellitus must learn how to self-administer insulin. The physician has ordered 10 units of U-100 regular insulin and 35 units of U-100 isophane insulin suspension (NPH) to be taken before breakfast. When teaching the client how to select and rotate insulin injection sites, the nurse should provide which instruction?
Rotate injection sites within the same anatomic region, not among different regions."
The nurse teaches a client with type 2 diabetes mellitus about diabetic retinopathy. Which statement if made by the client would indicate to the nurse that teaching was effective?
Tight control of blood sugar and blood pressure can prevent damage to my eye."
A client is admitted with hyperosmolar hyperglycemic nonketotic syndrome (HHNS). Which laboratory finding should the nurse expect in this client?
blood glucose level 1,100 mg/dl (61.05 mmol/L)
A client's blood glucose level is 45 mg/dl (2.5 mmol/L). The nurse should be alert for which signs and symptoms?
coma, anxiety, confusion, headache, and cool, moist skin
A client with type 1 diabetes mellitus is admitted to the emergency department. Which respiratory pattern in a client with diabetes mellitus requires immediate action?
deep, rapid respirations with long expirations
A client is admitted to the hospital with signs and symptoms of diabetes mellitus. Which of the following findings is the nurse most likely to observe in this client? Select all that apply.
excessive thirst excessive hunger frequent, high-volume urination
Levothyroxine 0.2 mg orally has been prescribed for a client diagnosed with hypothyroidism. The nurse has available 0.05-mg tablets. How many tablets should the nurse prepare to give the client?
four tablets
The nurse should teach the diabetic client that which is most indicative of hypoglycemia?
nervousness
Which goal is a priority for the diabetic client who is taking insulin and has nausea and vomiting from a viral illness or influenza?
obtaining adequate food intake
3 signs and symptoms of diabetes
polyuria polyphagia ploydipsia
A client who was diagnosed with type 1 diabetes 14 years ago is admitted to the medical-surgical unit with abdominal pain. On admission, the client's blood glucose level is 470 mg/dl (26.1 mmol/L). Which finding is most likely to accompany this blood glucose level?
rapid, thready pulse
Laboratory studies indicate a client's blood glucose level is 185 mg/dl (10.2 mmol/L). Two hours have passed since the client ate breakfast. Which test would yield the most conclusive diagnostic information about the client's glucose use?
serum glycosylated hemoglobin (Hb A1c)