Diabetes PrepU
Which clinical characteristic is associated with type 2 diabetes (previously referred to as non-insulin-dependent diabetes mellitus)?
HTN, tachycardia, stroke
Which electrolyte replacement should the nurse anticipate being ordered by the health-care provider in the client diagnosed with DKA who has just been admitted to the ICU? 1.Glucose. 2.)Potassium. 3.Calcium. 4.Sodium
Potassium
The client diagnosed with type 1 diabetes is found lying unconscious on the floor of the bathroom. Which intervention should the nurse implement first?
administer 50% dextrose
How to reverse hypoglycemia, what should the nurse tell the patient to keep on hand?
glucagon
A client tells the nurse that she has been working hard for the past 3 months to control her type 2 diabetes with diet and exercise. To determine the effectiveness of the client's efforts, the nurse should check:
glycosylated hemoglobin level
The client received 10 units of Humulin R, a fast-acting insulin, at 0700. At 1030 the CNA tells the nurse the client has a headache and is really acting "funny". which intervention should the nurse implement first?
go to the client's room and assess the client for hypoglycemia
A client with diabetes mellitus is receiving an oral antidiabetic agent. The nurse observes for which symptom when caring for this client?
hypoglycemia
For a client with hyperglycemia, which assessment finding best supports a nursing diagnosis of Deficient fluid volume?
increased urine osmolarity
The elderly client is admitted to the ICU diagnosed with severe HHNS. Which collaborative intervention should the nurse include in the plan of care?
infused 0.9% normal saline intravenously
Which statement is correct regarding glargine insulin?
it cannot be mixed with any other type of insulin
What should the nurse tell a patient with diabetes nephropathy to be cautious of?
monitor blood sugar level
A nurse expects to find which signs and symptoms in a client experiencing hypoglycemia?
nervousness, diaphoresis and confusion
the client diagnosed with HHNS was admitted yesterday with a blood glucose level of 780mg/dL. The clients blood glucose level is now 300mg/dL. Which intervention should the nurse implement?
notify the HCP to obtain an order to decrease insulin
The charge nurse is making client assignments in the ICU. Which client should be assigned to the most experienced nurse?
the client with DKA who has multifocal premature ventricular contractions
A nurse is preparing to administer insulin to a child who's just been diagnosed with type 1 diabetes. When the child's mother stops the nurse in the hall, she's crying and anxious to talk about her son's condition. The nurse's best response is:
"I'm going to give your son some insulin. Then ill be happy to talk with you"
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"
When administering insulin, which of the following is most important to keep in mind?
Accuracy of dose
An 18 year old female client, 5'4 tall, weighing 113 kg, comes to the clinic for a nonhealing wound on her lower leg, which she has had for 2 weeks. Which disease process should the nurse suspect the client has developed?
Type 2 diabetes
A client has been diagnosed with prediabetes and discusses treatment strategies with the nurse. What can be the consequences of untreated prediabetes?
Type 2 diabetes, heart disease and stroke
Which clinical manifestation of type 2 diabetes occurs if glucose levels are very high?
blurred vision
The client with type 2 diabetes controlled with biguanide oral diabetic medication is scheduled for a CT scan with contrast of the abdomen to evaluate pancreatic function. Which intervention should the nurse implement?
hold the biguanide medication for 48 hours prior to test
A client with type 1 diabetes has an elevated hemoglobin test, the nurse is most accurate in stating
it tells us your sugar results over 3 months
A client with type 1 diabetes presents with a decreased level of consciousness and a fingerstick glucose level of 39 mg/dl. 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 D5 solution, per physicians orders
Mixing regular and NPH insulin, what is important to teach the patient
draw up regular insulin first
the UAP on the medical floor tells the nurse the client diagnosed with DKA wants something else to eat for lunch. Which intervention should the nurse implement?
notify the dietician about the client's request
Which arterial blood gas results should the nurse expect in the client diagnosed with DKA?
pH: 7.30, Pao2: 90, Paco2: 30, HCO3: 18
Which of the following factors would a nurse identify as a most likely cause of diabetic ketoacidosis (DKA) in a client with diabetes?
the client has eaten and has not taken or received insulin
The nurse is teaching a client about self-administration of insulin and about mixing regular and neutral protamine Hagedorn (NPH) insulin. Which information is important to include in the teaching plan?
When mixing insulin, the regular insulin is drawn up into the syringe first
Which information should be included in the teaching plan for a client receiving glargine, a "peakless" basal insulin?
do not mix with other insulins
The nurse is discussing the importance of exercising with a client diagnosed with type 2 diabetes whose diabetes is well controlled with diet and exercise. Which information should the nurse include in the teaching about diabetes?
perform warm up and cool down exercises
The nurse is developing a care plan for the client diagnosed with type 1 diabetes. The nurse identifies the problem "high risk for hyperlgycemia R/T noncompliance with the medication regimen." which statement is an appropriate short-term goal for the client?
the client will have a blood glucose level between 90 and 140 mg/dL
What is the duration of regular insulin?
4-6 hours
The pancreas continues to release a small amount of basal insulin overnight, while a person is sleeping. The nurse knows that if the body needs more sugar:
The pancreatic hormone glucagon will stimulate the liver to release stored glucose
A patient has been newly diagnosed with type 2 diabetes, and the nurse is assisting with the development of a meal plan. What step should be taken into consideration prior to making the meal plan?
Reviewing the patient's diet history to identify eating habits and lifestyle and cultural eating patterns
A client with a history of type 1 diabetes is demonstrating fast, deep, labored breathing and has fruity odored breath. What could be the cause of the client's current serious condition?
ketoacidosis
The nurse is preparing to administer intermediate-acting insulin to a patient with diabetes. Which insulin will the nurse administer?
NPH
A client with status asthmaticus requires endotracheal intubation and mechanical ventilation. Twenty-four hours after intubation, the client is started on the insulin infusion protocol. The nurse must monitor the client's blood glucose levels hourly and watch for which early signs and symptoms associated with hypoglycemia?
Sweating, tremors, tachycardia
The client diagnosed with type 1 diabetes has a glycosylated hemoglobin (A1c) of 8.1%. Which interpretation should the nurse make based on this result?
This result is above recommended levels
Which intervention is essential when performing dressing changes on a client with a diabetic foot ulcer?
Using sterile technique during the dressing change
The nurse at a freestanding health-care clinic is caring for a 56-year old male client who is homeless and is a type 2 diabetic controlled with insulin. Which action is an example of patient advocacy?
arrange for someone to give him insulin at a local homeless shelter
the home health nurse is completing the admission assessment for a 76-year old client diagnosed with type 2 diabetes controlled with 70/30 insulin. Which intervention should be included in the plan of care?
assess the client's ability to read small print
the ER nurse is caring for a client diagnosed with HHNS who has a blood glucose level of 680mg/dL. Which question should the nurse ask the client to determine the cause of this acute complication?
"Have you has some type of infection lately?"
A nurse is teaching a client recovering from diabetic ketoacidosis (DKA) about management of "sick days." The client asks the nurse why it is important to monitor the urine for ketones. Which statement is the nurse's best response?
"Ketones accumulate in the blood and urine when fat breaks down in the absence of insulin. Ketones signal an insulin deficiency that will cause the body to start breaking down stored fat for energy."
the client is admitted to the ICU diagnosed with DKA. Which intervention should the nurse implement?
1. maintain adequate ventilation 2. assess fluid volume status 3. administer IV potassium 4. check for urinary ketones 5. monitor I&O
The diabetic educator is teaching a class on diabetes type 1 and is discussing sick-day rules. Which interventions should the diabetes educator include in the discussion? select all that apply
1. take diabetic medication even if unable to eat the client's normal diabetic diet 2. if unable to eat, drink liquids equal to the client's normal caloric intake 5. call the HCP if glucose levels are higher than 180mg/dL
A client with diabetes comes to the clinic for a follow-up visit. The nurse reviews the client's glycosylated hemoglobin test results. Which result would indicate to the nurse that the client's blood glucose level has been well-controlled?
6.5%
A nurse explains to a client that she will administer his first insulin dose in his abdomen. How does absorption at the abdominal site compare with absorption at other sites?
Insulin is absorbed more rapidly at abdominal injection sites than at other sites
A client with diabetes mellitus has a prescription for 5 units of U-100 regular insulin and 25 units of U-100 isophane insulin suspension (NPH) to be taken before breakfast. At about 4:30 p.m., the client experiences headache, sweating, tremor, pallor, and nervousness. What is the most probable cause of these signs and symptoms?
Serum glucose level of 52 mg/dl
A client's blood glucose level is 45 mg/dl. The nurse should be alert for which signs and symptoms?
coma, anxiety, confusion, headache, and cool, moist skin
Which of the following would be considered a "free" item from the exchange list?
diet soda
The client diagnosed with type 2 diabetes is admitted to the ICU with hyperosmolar hyperglycemia nonketoic syndrome (HHNS) coma. Which assessment data should the nurse expect the client to exhibit?
dry mucous membranes
the nurse administering 28 units of Humulin N, an intermediate acting insulin, to a client diagnosed with type 1 diabetes at 1600. Which intervention should the nurse implement?
ensure the client eats the bedtime snack
A client with type 1 diabetes asks the nurse about taking an oral antidiabetic agent. The nurse explains that these medications are effective only if the client:
has type 2 diabetes
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 anatomical region, not among different regions
the nurse is discussing ways to prevent DKA with the client diagnosed with type 1 diabetes. Which instruction is most important to discuss with the client?
take the prescribed insulin even when unable to eat because of illness
The nurse is assessing the feet of a client with long-term type 2 diabetes. Which assessment data warrant immediate intervention by the nurse?
the client has a necrotic big toe
Which assessment data indicate the client diagnosed with DKA is responding to the medical treatment?
the client is A&Ox3
