CHapter 51: Medical Surgical Nursing

Presence of autoantibodies against islet cells

A nurse is teaching a diabetic support group about the causes of type 1 diabetes. The teaching is determined to be effective when the group is able to attribute which factor as a cause of type 1 diabetes?

A client has been diagnosed with prediabetes and discusses treatment strategies with the nurse. What can be the consequences of untreated prediabetes?

All options are correct. Explanation: The NIDDK has developed criteria that identify people with prediabetes, which can lead to type 2 diabetes, heart disease, and stroke.

Which type of insulin acts most quickly?

Lispro

intermediate acting

NPH is an example of which type of insulin?

A nurse expects to find which signs and symptoms in a client experiencing hypoglycemia?

Nervousness, diaphoresis, and confusion

Ketoacidosis (DKA)

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?

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 I'll be happy to talk with you."

Hypoglycemia symptoms

A client with diabetes mellitus is receiving an oral antidiabetic agent. The nurse observes for which symptom when caring for this client?

A client is taking glyburide (DiaBeta), 1.25 mg P.O. daily, to treat type 2 diabetes. Which statement indicates the need for further client teaching about managing this disease?

"I skip lunch when I don't feel hungry."

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."

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.

8:30 AM. Explanation: Short-acting insulin reaches its peak effectiveness 2 to 3 hours after administration. See Table 30-3 in the text.

A health care provider prescribes short-acting insulin for a patient, instructing the patient to take the insulin 20 to 30 minutes before a meal. The nurse explains to the patient that Humulin-R taken at 6:30 AM will reach peak effectiveness by:

A client has gained 55 lbs. in the last three years and is concerned about developing type 2 diabetes mellitus, especially since the client's parents both have developed the disorder. What percentage of people affected by diabetes mellitus acquired the disorder as adults?

90%

polyphagia

A client has been recently diagnosed with type 2 diabetes, and reports continued weight loss despite increased hunger and food consumption. This condition is called:

Albumin

A nurse is caring for a diabetic patient with a diagnosis of nephropathy. What would the nurse expect the urinalysis report to indicate?

A nurse is preparing a client with type 1 diabetes for discharge. The client can care for himself; however, he's had a problem with unstable blood glucose levels in the past. Based on the client's history, he should be referred to which health care worker?

Dietitian

Which statement is correct regarding glargine insulin?

It cannot be mixed with any other type of insulin.

In 2006, the National Council of State Boards of Nursing (NCSBN) and the American Nurses Association (ANA) jointly issued a statement on the delegation of nursing duties. This document specifies the five rights of delegation. What do these five rights include? Select all that apply.

Right circumstances Right task Right direction/communication Right person Explanation: The five rights include the right task, right circumstances, right person, right direction/communication, and right supervision/evaluation.

Laboratory studies indicate a client's blood glucose level is 185 mg/dl. 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)

After being sick for 3 days, a client with a history of diabetes mellitus is admitted to the hospital with diabetic ketoacidosis (DKA). The nurse should evaluate which diagnostic test results to prevent dysrhythmias?

Serum potassium level

Regular

What is the only insulin that can be given intravenously?