Adult Health Ch. 64, Care of Patients with Diabetes Mellitus

The nurse is caring for a patient who has just developed a meal plan after being diagnosed with diabetes. Which statement by the patient reflects an accurate understanding of the teaching provided?

"I am glad I'll be able to still eat some of my usual foods."

The nurse is providing discharge teaching to a patient with diabetes about injury prevention for peripheral neuropathy. Which statement by the patient indicates a need for further teaching?

"I can break in my shoes by wearing them all day."

The nurse is teaching a patient with diabetes about proper foot care. Which statement by the patient indicates that teaching was effective?

"I must inspect my shoes for foreign objects before putting them on."

The nurse is teaching a patient with type 2 diabetes about the importance of weight control. Which comment by the patient indicates a need for further teaching?

"I should begin exercising for at least an hour every day."

The nurse is teaching a patient about the manifestations and emergency treatment of hypoglycemia. In assessing the patient's knowledge, the nurse asks the patient what he or she should do if feeling hungry and shaky. Which response by the patient indicates a correct understanding of hypoglycemia management?

"I should eat three graham crackers."

A patient diagnosed with diabetes has received education regarding safety with exercise. What statement by the patient demonstrates a need for further teaching?

"I should not exercise if my blood sugar is over 150 mg/dL

The nurse is evaluating teaching that has been provided to a patient who was recently diagnosed with diabetes. What statement indicates a need for further teaching?

"I will avoid eating fatty fish."

Which patient statements indicate that he or she has understood teaching regarding neuropathy? Select all that apply.

"I will inspect my feet every day." "I will take my prescribed gabapentin." "I will try to keep my blood glucose level steady."

The nurse is providing nutritional recommendations for a patient who has been diagnosed with diabetes. What statement by the patient indicates a need for further teaching?

"I will maintain an 1800 calorie diet."

The nurse is providing discharge teaching to a patient with newly diagnosed diabetes. Which statement by the patient indicates a correct understanding about the need to wear a MedicAlert bracelet?

"If I become hypoglycemic, I could become unconscious."

The nurse is providing instructions to a patient scheduled for a fasting plasma glucose (FPG) test for diabetes screening. What statement by the patient reflects a need for further teaching?

"It is important not to eat 12 hours before the labs are drawn."

A patient is scheduled for a glycosylated hemoglobin (A1C) test. The patient calls to request the day be changed because he has a family function the weekend before the test and is concerned about following the nutritional plan. What statement by the nurse is most appropriate?

"The A1C test will not be affected by what you eat in the days before it."

Which blood glucose level does the operating room nurse recognize as optimal during surgery to prevent hypoglycemia?

150 mg/dL

Which patient does the nurse identify as needing screening for type 2 diabetes?

A 46-year-old patient with no health history

A registered nurse is teaching a group of nursing students about the recommendation of the American Diabetes Association (ADA) regarding indications for testing an individual with type 2 diabetes. Which individual suggested by a nursing student for testing indicates a need for further education?

An individual who is 45 years old with a body mass index (BMI) less than 25 kg/m2

The nurse is providing education to a patient with a new diagnosis of type 1 diabetes. What action by the patient indicates a need for further teaching?

Aspirating for blood return before administering the medication

A patient with type 1 diabetes and a limited income is under nursing care. What nutritional teachings will the nurse provide to the patient? Select all that apply.

Avoid gaining weight. Dietary information should be shared with the person who prepares the meals.

The nurse is providing teaching about weight gain secondary to insulin resistance to a patient with type 1 diabetes. What actions by the patient can minimize this complication?

Calorie restriction

A patient newly diagnosed with diabetes is not ready or willing to learn diabetes control during the hospital stay. Which information is the priority for the nurse to teach the patient and the patient's family?

Cause and treatment of hypoglycemia

Which are priority interventions for a diabetic patient to reduce modifiable risk factors associated with cardiovascular disease? Select all that apply.

Ceasing smoking Controlling hypertension Controlling hyperglycemia Controlling high triglycerides

What action is important for a patient with diabetes to take on sick days?

Check urine for ketones.

The nurse is providing education regarding sick day rules to a patient with diabetes. What information does the nurse include in the teaching plan? Select all that apply.

Check urine for ketones. Monitor blood glucose at least every 4 hours. Drink 8 to 12 ounces of sugar-free liquid every hour while awake

A patient with type 2 diabetes is in for a routine physical. The patient has a fasting blood glucose level of 90 mg/dL and a glycosylated hemoglobin (A1C) level of 9%. What action by the nurse is priority?

Discuss dietary adherence with the patient.

What teaching regarding insulin administration should the nurse include in patient teaching? Select all that apply.

Disposable syringes should be used only once. It is important to use the same type of syringe regularly

The nurse has provided teaching about exercise to a patient diagnosed with type 1 diabetes. What action by the patient demonstrates effective teaching?

Eat a carbohydrate snack if participating in unplanned exercise.

When providing teaching about nutrition to a patient diagnosed with diabetes, what instruction should the nurse include?

Eat consistent amounts of food at consistent times.

What information about exercise should the nurse include for patients diagnosed with diabetes? Select all that apply.

Exercise increases insulin sensitivity. Hypoglycemia can occur from increased muscle glucose uptake. Exercise can lead to hyperglycemia and ketones if diabetes is not controlled.

The nurse is providing health screening. The nurse determines that the patient with which lab value should receive teaching related to diabetes?

Fasting blood glucose of 127 mg/dL

A patient has been newly diagnosed with diabetes mellitus. Which factors does the nurse emphasize should be monitored regularly by the patient to prevent and detect complications of the disease? Select all that apply.

Feet Urine Vision Kidney function Hemoglobin A1c

The nurse is providing education for a patient newly diagnosed with diabetes. The patient is discussing healthy sources of carbohydrates. What sources should be included? Select all that apply.

Fruits Legumes Low-fat milk products

The nurse is providing teaching to a patient at risk for the development of type 2 diabetes. The nurse explains which benefits of exercise for this patient? Select all that apply.

Glucose tolerance Reduced body weigh

The home health care nurse is providing teaching to an insulin-dependent patient regarding infection. What symptom is priority for the patient to report to the health care provider?

Hyperglycemia

The nurse has provided education about factors responsible for increased rates of diabetes among minority groups. Which factor identified by the patient indicates a need for further teaching?

Increased financial resources

The nurse is providing education to a patient about the prevention of hypoglycemia. What signs and symptoms of this complication should be included in the teaching?

Irritability

The nurse is screening patients in a clinic. What groups have a higher risk of developing type 2 diabetes? Select all that apply.

Mexican Americans Patients with glucose intolerance during pregnancy

The nurse is providing screening for patients about diabetes mellitus. What diagnoses does the nurse recognize as triggers for development of type 1 diabetes mellitus? Select all that apply.

Mumps Coxsackievirus

The nurse is planning nutritional education for a patient newly diagnosed with diabetes. Who should be included as part of the treatment team? Select all that apply.

Nurse Patient's family Registered dietician

The nurse is treating a patient with diabetes. Which are risk factors for development of vision loss in patients with diabetes? Select all that apply.

Proteinuria Poor glucose regulation

The nurse is determining the learning needs of a patient diagnosed with diabetes. What items should the nurse include in this assessment? Select all that apply.

Psychosocial concerns Current mental health status Nutrition history and practices

The nurse is providing teaching to a patient diagnosed with peripheral neuropathy secondary to diabetes. Which instructions regarding footwear should be included for the patient?

Socks or stockings should be fitted properly.

The nurse is providing preoperative instructions to a patient with diabetes. What instructions should the nurse include?

Sulfonylureas should be discontinued one day before surgery.

The nurse is assessing a patient for diabetic foot problems. What should the nurse include in this assessment? Select all that apply.

Toenails Tinea pedis History of previous ulcer

Under what circumstances does the nurse teach a patient with diabetes to contact the primary health care provider? Select all that apply.

Unable to take food or fluids Ketonuria lasting longer than 24 hours