Chapter 51 study guide questions

Ketoacidosis

The most common risk of insulin pump therapy

C

The nurse expects that a patient with type 1 diabetes may receive what percentage of the usual morning dose of insulin preoperatively? A. 10% to 20% B. 25% to 40% C. 50% to 60% D. 85% to 90%

B

The nurse is administering an insulin drip to a patient in ketoacidosis. What insulin does the nurse know is the only one that can be used intravenously? A. NPH B. Regular C. Lispro D. Lantus

A,B,C

The nurse is assessing a patient with nonproliferative (background) retinopathy. When examining the retina, what would the nurse expect to assess? (Select all that apply) A. Leakage of fluid or serum (exudates) B. Microaneurysms C. Focal capillary single closure D. Detachment E. Blurred optic discs

A,B,C

The nurse is educating the patient with diabetes about the importance of increasing dietary fiber. What should the nurse explain is the rationale for the increase? (Select all that apply) A. May improve blood glucose levels B. Decrease the need for exogenous insulin C. Help reduce cholesterol levels D. May reduce postprandial glucose levels E. Increase potassium levels

A

The nurse is preparing to administer intermediate-acting insulin to a patient with diabetes. Which insulin will the nurse administer? A. NPH B. Iletin II C. Humalog D. Glargine

A

The nurse is caring for a patient with an abnormally low blood glucose concentration. What glucose level will the nurse observe when assessing laboratory results? A. Lower than 50 to 60 mg/dL B. Between 60 and 80 mg/dL C. Between 75 and 90 mg/dL D. 95 mg/dL

A

A female patient with diabetes who weighs 130 lb has an ideal body weight of 116 lb. For weight reduction of 2 lb/wk, approximately what should her daily caloric intake be? A. 1000 calories B. 1200 calories C. 1500 calories D. 1800 calories

A

A nurse is caring for a patient with diabetes that has a diagnosis of neuropathy. What would the nurse expect the urinalysis report to indicate? A. Albumin B. Bacteria C. Red blood cells D. White blood cells

Glycogenolysis

Because insulin normally inhibits _____________ and gluconeogenesis, these processes occur in an unrestrained fashion in people with insulin deficiency and contribute further to hyperglycemia.

Hypokalemia

Christine, a 64 year old woman, is admitted to the clinical area with a diagnosis of diabetic ketoacidosis. Christine lives alone and is frequently nonadherent with her dietary and medication regimen. She has had several admissions prior to this one. On admission, she is drowsy yet responsive. As blood glucose levels approach normal, what electrolyte imbalance should the nurse assess for?

Monitoring urinary output by means of an indwelling catheter, evaluating serum electrolytes, testing for glucosuria, and acetonuria, blood glucose testing, and vital signs

Christine, a 64 year old woman, is admitted to the clinical area with a diagnosis of diabetic ketoacidosis. Christine lives alone and is frequently nonadherent with her dietary and medication regimen. She has had several admissions prior to this one. On admission, she is drowsy yet responsive. What priority actions should the nurse take in caring for Christine?

Polyguria

Classic clinical manifestations of diabetes include the "three P's" ____________, polydipsia, and polyphagia.

Glycosuria

Filtered glucose that the kidney cannot absorb spills over into urine

18

Gestational diabetes occurs in as many as _______% of pregnant women and increases their risk for hypertensive disorders during pregnancy.

Glycogenolysis

Glycogen breaks down in the liver through the action of glucagon

105

Goals for blood glucose levels during pregnancy are ________ mm/dL or less before meals and 130 mm/dL or less 2 hours after meals

Blindness

In the United States, diabetes is the leading cause of no traumatic amputation, ____________, and end stage kidney disease.

Decreased

Insulin resistance refers to a ____________ tissue sensitivity to insulin

25.8

It is estimated that more than __________ million people in the United States have diabetes, although almost one third of these cases are undiagnosed.

Retinopathy

Microvascular changes develop in the eyes

Gluconeogenesis

New glucose is produced from amino acids

Nephropathy

Small vessel disease affects the kidneys

D

The nurse is educating a patient about the benefits of fruit versus fruit juice in the diabetic diet. The patient states " What difference does it make if you drink the juice or eat the fruit?" What is the best response by the nurse? A. "Eating the fruit is more satisfying than drinking the juice. You will get full faster." B. " Eating the fruit will give you more vitamins and minerals than the juice will" C. " The fruit has less sugar than the juice D. " Eating the fruit instead of drinking the juice decreases the glycemic index by slowing absorption"

C

The nurse is preparing to administer IV fluids for a patient with ketoacidosis who has a history of hypertension and congestive heart failure. What order for fluids would the nurse anticipate infusing for this patient? A. D5W B. 0.9% normal saline C. 0.45% normal saline D. D5 normal saline

Seventh

Type 2 diabetes is the ___________ leading cause of death and affects approximately 20% of older adults

Hyperglycemic hyperosmolar syndrome

Uncontrolled type 2 diabetes may lead to an acute problem such as

Osmotic diuresis

When excess glucose is excreted in the urine, it is accompanied by excessive loss of fluids and electrolytes called:

A

When the nurse is caring for a patient with type 1 diabetes, what clinical manifestation would be a priority to closely monitor? A. Hypoglycemia B. Hyponatremia C. Ketonuria D. Polyphagia

A,B,D

A patient is diagnosed with type 1 diabetes. What clinical characteristics does the nurse expect to see in this patient? (Select all that apply) A. Ketosis prone B. Little endogenous insulin C. Obesity at diagnoses D. Younger than 30 years of age E. Older than 65 years of age

When hanging the insulin drip, the nurse must flush the insulin solution through the entire IV infusion set and discard the first 50 mL of fluid. Insulin molecules adhere to the inner surface of plastic IV infusion sets; therefore the initial fluid may contain a decreased concentration of insulin

Christine, a 64 year old woman, is admitted to the clinical area with a diagnosis of diabetic ketoacidosis. Christine lives alone and is frequently nonadherent with her dietary and medication regimen. She has had several admissions prior to this one. On admission, she is drowsy yet responsive. The healthcare provider orders an insulin drip to be started at 5 units/hr. When hanging the drip, what should the nurse do prior to connecting the drip to the patient?

Gestational

The major classifications of diabetes are: type 1 diabetes, type 2 diabetes, and ____________, and diabetes associated with other conditions or syndromes.

B

An older adult patient is in the hospital being treated for sepsis related to a urinary tract infection. The patient has started to have an altered sense of awareness, profound dehydration, and hypotension. What condition does the nurse suspect the patient is experiencing? A. Systemic inflammatory response syndrome B. Hyperglycemic hyperosmolar syndrome C. Multiple-organ dysfunction syndrome D. Diabetic ketoacidosis

Elevated

A finding of _________ blood glucose levels is the basic criterion for the diagnosis of diabetes.

C

An older adult patient that has diabetes type 2 comes to the emergency department with second-degree burns to the bottom of both feet and states " I didn't feel too hot but my feet must have been too close to the heater." What does the nurse understand is most likely the reason for the decrease in temperature sensation? A. A faulty heater B. Autonomic neuropathy C. Peripheral neuropathy D. Sudomotor neuropathy

D

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? A. Make sure that the patient is aware that quantity of foods will be limited B. Ensure that the patient understands that some favorite foods may not be allowed on the meal plan and substitutes will need to be found C. Determine whether the patient is on insulin or taking oral antidiabetic medication D. Review the patient's diet history to identify eating habits, and lifestyle and cultural eating patterns

A

A patient with diabetic ketoacidosis has had a large volume of fluid infused for rehydration. What potential complication from rehydration should the nurse monitor for? A. Hypokalemia B. Hyperkalemia C. Hyperglycemia D. Hyponatremia

24

A woman at average risk for the development of hyperglycemia during pregnancy should be tested at _______ to 28 weeks of gestation

Hyperkalemia

Christine, a 64 year old woman, is admitted to the clinical area with a diagnosis of diabetic ketoacidosis. Christine lives alone and is frequently nonadherent with her dietary and medication regimen. She has had several admissions prior to this one. On admission, she is drowsy yet responsive. What laboratory results would the nurse expect to find that may be associated with Christine's condition?

0.9% sodium chloride

Christine, a 64 year old woman, is admitted to the clinical area with a diagnosis of diabetic ketoacidosis. Christine lives alone and is frequently nonadherent with her dietary and medication regimen. She has had several admissions prior to this one. On admission, she is drowsy yet responsive. What rehydrating intravenous solution does the nurse expect to infuse?

Hyperglycemia

___________, ketosis, and metabolic acidosis are the three metabolic derangements that occur in diabetic ketoacidosis