Diabetes

A nurse is reinforcing dietary teaching to a client who has type 2 diabetes mellitus. Which of the following instructions should the nurse include?

"Carbohydrates should comprise 55% of daily caloric intake."; "You can add table sugar to cereals."; "Eat something if you choose to drink alcohol."; "Use the same portion sizes to exchange carbohydrates."

A nurse is teaching a child who has type 1 diabetes mellitus about self-care. Which of the following statements by the child indicates understanding of the teaching?

"I should drink a glass of milk when I am feeling irritable."

A nurse is teaching a group of clients who have diabetes about meal planning. Which of the following client statements indicates understanding?

"I will not eat fruit canned in syrup."

A nurse is providing teaching to a client who has type 2 diabetes mellitus and is starting repaglinide. Which of the following statements by the client indicates understanding of the administration of this medication?

"I'll take this medicine 30 minutes before I eat."

The client with type 2 insulin-requiring diabetes asks the nurse about having alcoholic beverages. Which is the best response by the nurse?

"You can have one or two drinks a day as long as you have something to eat with them.:

A nurse is teaching clients about the use of insulin to treat type 1 diabetes mellitus. For which of the following types of insulin should the nurse tell the clients to expect a peak effect 1 to 5 hr after administration?

Regular insulin

A nurse is participating in a diabetes screening program. Which clients are at risk for developing type 2 diabetes?

A 32-year-old female who gave birth to a 9.5 lb infant; a 44 year old Native American who has a body mass index of 32; a 55 year old Asian who has hypertension and two siblings with type 2 diabetes; a 12 year old who is overweight.

Which information should the nurse include when developing a teaching plan for a client newly diagnosed with type 2 diabetes mellitus?

A major risk factor for complications is obesity and central abdominal obesity; Annual eye and foot examinations are recommended by the American and Canadian Diabetes Associations.

A nurse is assessing a client who has diabetic ketoacidosis and ketones in the urine. The nurse should expect which of the following findings?

Abdominal pain; Kussmaul respirations; Metabolic acidosis.

A nurse is preparing to administer a morning dose of insulin aspart to a client who has type ` diabetes mellitus. Which of the following actions should the nurse take?

Administer insulin when breakfast arrives.

A nurse is talking with a client who has a new diagnosis of diabetes mellitus type 2 and their caregiver. Which of the following sweeteners should the nurse include as a zero-calorie sweetener option?

Aspartame, sucralose

When teaching the diabetic client about foot care, what should the nurse instruct the client to do?

Avoid going barefoot.

An adult with type 2 diabetes mellitus has been NPO since 2200 in preparation for having a nephrectomy the next day. At 0600 on the day of surgery, the nurse reviews the client's medical record and laboratory results. Which finding should the nurse report to the health care provider?

Blood glucose of 140 mg/dL

The nurse is checking the laboratory results of an adult client with type 1 diabetes. What laboratory result indicates a problem that should be managed?

Blood glucose of 192 mg/dL

A nurse is reviewing laboratory reports of a client who has HHS. Which of the following findings should the nurse expect?

Blood osmolarity 350 mOsm/L

A client with newly diagnosed type 1 diabetes is scheduled to receive regular insulin 10 units and NPH insulin 20 units every morning. When should the nurse schedule the administration of these medications?

Both insulins 0.5 hours before breakfast.

A client with type 2 insulin-requiring diabetes has the flu with nausea, body aches, and lack of appetite. The client's blood sugar is 180 mg/dL. The vital signs are t101, p88, and r20. What should the nurse instruct the client to do?

Check blood sugar every 4 hours; Drink 240 mL fluids every hour.

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 HCP about removing them.

The client with diabetes mellitus says, "If I could just avoid what you call carbohydrates in my diet, I guess I would be okay." The nurse should base the response to this comment on the knowledge that diabetes affects metabolism of which nutrients?

Proteins, fats, and carbohydrates.

A nurse is caring for a client who has blood glucose 52 mg/dL. The client is lethargic but arousable. Which of the following actions should the nurse perform first?

Provide 15 g of simple carbohydrates.

A client is to receive glargine insulin in addition to a dose of aspart. When the nurse checks the blood glucose level at the bedside, it is >200 mg mg/dL. How should the nurse administer the insulins?

Put air into the glargine insulin vial, and draw up the correct dose in an insulin syringe, put air into the aspart vial, and draw up the correct dose.

A constellation of conditions that place people at high risk for coronary artery disease. These conditions include type 2 diabetes, obesity, high blood pressure, and a poor lipid profile with elevated LDL cholesterol, low HDL cholesterol, and elevated triglycerides?

Metabolic Syndrome

A client with type 1 diabetes is admitted to the emergency department. Which respiratory pattern in a client with diabetes requires immediate action?

Deep, rapid respirations with long expirations.

A class of oral hypoglycemic agents (medications that lower the level of blood glucose) taken by people with type 2 diabetes.

Sulfonylurea

A nurse is teaching foot care to a client who has diabetes mellitus. Which of the following information should the nurse include in the teaching?

Trim toenails straight across; wear closed-toe shoes.

A nurse is caring for a child who has type 1 diabetes mellitus. Which of the following are manifestations of diabetic ketoacidosis?

Dehydration; Mental Confusion; Fruity breath.

A nurse is assessing a client who has hypoglycemia. Which of the following findings should the nurse expect?

Diaphoresis

A nurse is preparing to administer morning doses of insulin glargine and regular insulin to a client who has a blood glucose 278 mg/dL. Which of the following actions should the nurse take?

Draw up and administer regular and glargine insulin in separate syringes.

A nurse is providing discharge teaching to a client who had diabetic ketoacidosis. Which of the following information should the nurse include about preventing DKA?

Drink 2 L fluids daily; Monitor blood glucose every 4 hr when ill; Administer insulin as prescribed when ill; Report ketones in the urine after 24 hr of illness.

A nurse is presenting information to a group of clients about nutrition habits that prevent type 2 diabetes mellitus. Which of the following should the nurse include in the information?

Eat at regular intervals; Decrease intake of saturated fats; Increase daily fiber intake; Include omega-3 fatty acids in the diet.

A nurse is reviewing the health history of a client who has diabetes mellitus type 2. Which of the following are risk factors for hyperglycemic hyperosmolar state (HHS)?

Evidence of recent myocardial infarction; Bun 35 mg/dL; Takes a calcium channel blocker; Age 77 years.

The nurse is obtaining a health history from a client with diabetes mellitus who has been taking insulin for 20 years. Currently, the client reports having periods of hypoglycemia followed by periods of hyperglycemia. What should the nurse ask about the client's current management plan?

Is the client injecting insulin at a site of lipodystrophy?

A nurse is caring for a client who has been taking acarbose for type 2 diabetes mellitus. Which of the following laboratory tests should the nurse plan to monitor?

Liver function tests.

When evaluating teaching a client how to administer insulin, which action indicates that additional teaching is necessary?

Waits 30 minutes to eat breakfast after injecting rapid-acting insulin.

Hemoglobin to which glucose is bound. It is tested to monitor the long-term control of diabetes mellitus.

Glycosylated hemoglobin

Before supper, an adult client who has type 2 diabetes and requires insulin tells the nurse about having tremors and being weak and anxious. What should the nurse do next?

Have the client drink a glass of milk or orange juice.

A chemical substance produced in the body that controls and regulates the activity of certain cells or organs.

Hormone

A nurse is teaching an adolescent who has diabetes mellitus about manifestations of hypoglycemia. Which of the following findings should the nurse include in the teaching?

Hunger; Irritability; Sweating and pallor.

A nurse is reviewing sick-day management with a parent of a child who has type 1 diabetes mellitus. Which of the following should the nurse include in the teaching?

Monitor blood glucose levels every 3 hours; Test urine for ketones; Call the provider if blood glucose is greater than 240 mg/dL.

The nurse is coaching a diabetic client using an empowerment approach. The nurse should initiate teaching by asking which question?

"What activities are most important for you to be able to maintain control of your diabetes?"

The health care provider has prescribed insulin detemir for a client with type 2 diabetes requiring insulin. What should the nurse teach the client about this insulin?

"You do not mix insulin detemir; the solution is clear."

A nurse is teaching a school-age child who has diabetes mellitus about insulin administration. Which of the following should the nurse include in the teaching?

"You should give four to six injections in one area before switching sites."

An adult with type 2 diabetes is taking metformin 1,000 mg two times every day. The client asks the nurse about having an alcoholic drink. Which statement indicates the client understands the interaction of alcohol and metformin?

"If I know I'll be having alcohol, I shouldn't take metformin."

A nurse is providing teaching to a client who has a prescription for pramlintide for type 1 diabetes mellitus. Which of the following should the nurse include in the teaching?

"Inject pramlintide just before a meal."; "Discard open vials after 28 days."

A client with diabetes mellitus presents to the clinic for a regular 3-month follow-up appointment. The nurse notes several small bandages covering cuts on the client's hands. The client says, "I'm so clumsy. I'm always cutting my finger cooking or burning myself on the iron." Which response by the nurse would be most appropriate?

"Keep all cuts clean and covered."

A client with type 1 diabetes mellitus has diabetic ketoacidosis. Which finding has the greatest effect on fluid loss?

Rapid, deep respirations.

A nurse is reviewing the medical record for a client who is to begin therapy for DKA. Which of the following prescriptions should the nurse expect?

Rapidly administer an IV infusion of 0.9% sodium chloride.

A nurse is providing teaching for a client who has a new prescription for metformin. Which of the following findings should the nurse instruct the client to report as an adverse effect of metformin?

Somnolence

A client is to use an insulin pen. Which action indicates the client is using the pen correctly?

Stores the unopened pens in the refrigerator; Injects the insulin in sites around the abdomen; Primes the pen by expelling any air.

The client has been recently diagnosed with type 2 diabetes and is taking metformin two times per day, 1,000 mg before breakfast and 1,000 mg before supper. The client is experiencing diarrhea, nausea, lvomiting, abdominal bloating, and anorexia on admission to the hospital. The admission prescriptions include metformin. What should the nurse do?

Inform the client that the adverse effects of diarrhea, nausea, and upset stomach gradually subside over time; Assess the client's renal function; Monitor the client's glucose value prior to each meal.

A nurse is caring for a client who has diabetes mellitus and reports feeling shaky and weak. The client's blood glucose is 53 mg/dL. Which of the following actions should the nurse take?

Offer the client 120 mL (4oz) fruit juice.