diabetes continued foot care nutrition sick day rules

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 select all that apply? A. Remove calluses using over-the-counter remedies B. Apply lotion between the toes C. Perform Nail Care after bathing D. Trim toenails straight across E. Wear closed-toed shoes

C. perform Nail Care after D. trim toenails straight across E. wear closed-toe shoes

recognize that blank carbohydrates is equal to one carbohydrate Exchange

15 grams

a nurse is caring for a client who has blood glucose 52 mg slash DL. The client is lethargic but arousal which of the following actions should the nurse perform first? a. recheck blood glucose in 15 minutes b. provide a carbohydrate and protein food c. provide 4 oz of grape juice d. report findings to the provider

C. provide 4 oz of grapefruit juice

_______ calories and __________ physical activity as appropriate to facilitate weight loss for clients who are overweight

restrict calories and increase

a nurse is preparing to administer a morning dose of insulin aspart to a client who has Type 1 diabetes which of the following actions should the nurse implement? A. check blood glucose immediately after breakfast B. administer insulin when breakfast arrives C. hold breakfast for 1 hour after insulin Administration D. clarify the prescription because insulin should not be administered at this time

B. administer insulin when breakfast

a nurse is preparing to administer morning dose of insulin glargine and regular insulin to a client who has a blood glucose to 78 mg DL. Which of the following actions should the nurse take? a. draw up the regular insulin and then the glargine insulin in the same syringe b. draw up the glargine insulin than the regular insulin in the same syringe c. draw up and administer regular and glargine insulin and separate syringes d. administer the regular insulin, wait one hour, and then administer the glargine insulin

C. draw up and administer regular and gargling insulin and supper

teach the client to follow facility policy or recommendations of a podiatrist for Nail Care

some protocols allow for trimming toenails straight across with clippers and filing edges with an emery board or nail file to prevent soft tissue injury if Clippers or scissors are contraindicated a client to file the nail straight across

a nurse is presenting information to a group of clients about nutrition habits that prevent type 2 diabetes. Which of the following should the nurse include in the information select all that apply A. Eat less meat and processed foods B. Decrease intake of saturated fats. C. Increase daily fiber intake. D. Limit saturated fat intake to 15% of daily caloric intake. E. Include omega-3 fatty acids in the diet

a. eat less meats and processed foods B.decrease intake of saturated fats C.increase daily fiber intake E. include omega-3 fatty acids in the diet

the best time to perform Nail Care is

after a bath or a shower when the toenails are soft and easier to trim cut toenails straight across

plan meals to achieve

appropriate timing of food intake, activity, onset, and peak of insulin. Calories in food composition should be similar each day. Eat at regular intervals and do not skipping meals.

prolonged sitting, standing and crossing of legs the patient should

avoid

count grams of_______ consumed for glycemic control

carbohydrates

nutritional guidelines for diabetes

consult a dietitian for collaborative education with a client and family on meal planning to include food intake, weight management, and lipid and glucose management.

diabetic nephropathy

damage to the kidneys from prolonged elevated blood glucose levels and dehydration

diabetic retinopathy

degenerative changes of the retina caused by diabetes mellitus; may lead to blindness

use or do not use commercial remedies for the removal of calluses or corns which can increase the risk for tissue injury and infection

do not use commercial remedies

read and interpret______ content information on food labels to keep saturated fats Within _______ of the recommendations of the daily total calorie intake

fat 7%

cardiovascular and cerebrovascular complications from diabetes

hypertension, myocardial infarction stroke

include in the diet to increase carbohydrate metabolism and to help control cholesterol levels

include fiber in the diet

diabetes foot care

inspect feed daily. Wash feed daily with mild soap and warm water test water temperature with hand soap for washing feet

Foot Care: should you use lotion between the toes?

pat dry gently especially between the toes and avoid lotions between the toes to decrease excess moisture and prevent infection. use a mild foot powder on sweaty feet

teach the client to cleanse Cuts with

warm water and Mild soap, gently dry, and apply dry dressing. Instruct the client to monitor healing and to seek intervention promptly

you should avoid what type of shoes

●avoid open toe, open heel shoes. Leather shoes are preferred to plastic. Wear shoes that fit correctly. Wear slippers with soles. Do not go barefoot. ● we're clean or absorbent socks or stockings that are made of cotton or wool and have not been mended. ● do you not use hot water bottles or heating pads to warm feet wear socks for warm

sick day rules call the provider for the following

●blood glucose greater than 240. Test urine for ketones if prescribed. ●fever greater than 101.5 does not respond to see two medicine or less one 24 hours. ●feeling disoriented experiencing rapid breathing vomiting that occurs more than once ●diarrhea that occurs more than 5 times for longer than 24 hours inability to tolerate ●illness that last longer than 2 days

cardiovascular and cerebral vascular disease client education related to diabetes

●encourage checkups of cholesterol HDL, LDL and triglycerides yearly and monitoring of blood pressure less than 130 over 80 and hemoglobin A1c every 3 months ● encourage participation regular activities for weight loss and control ●encourage a diet of low fat meals that are high in fruits vegetables and whole grains ●teach the client to reports shortness of breath, headaches numbness in distal extremities, swelling of feet, and frequent urination and changes in vision. ●encourage a dietary consult

diabetic retinopathy client education

●encourage yearly eye exams to ensure the health of the eyes and to protect vision. ●Encourage management of low glucose levels

diabetic neuropathy

●false from damage to sensory nerve fibers resulting in numbness and pain is Progressive ●can affect every aspect of the body and can lead to ischemia and infection

a nurse is providing guidelines to a client who has Type 1 diabetes about self-care during illness what lab test should be done what client education should be done?

●lab test: test urine for ketones and report to provider if abnormal ●client education: >monitor blood glucose every 3 to 4 hours >continue totake insulin as prescribed >prevent dehydration by consuming to 2/3 of fluid obtained from food and beverages with artificial sweetener and drinking an adequate amount of water >call provider if unable to tolerate liquids if unable to eat soft foods, consume liquids equal to usual carbohydrate content >call the provider for illness longer than 2 days or diarrhea more than 5 episodes or for longer than 24 hours >call the provider for fever that is greater than 101.5 Fahrenheit which does not respond to acetaminophen or less more than 24 hours

Sick day rules

●monitor blood glucose every 3 to 4 hours ●continue to take insulin or oral hypoglycemic ●consume 4 oz of sugar-free non-caffeinated liquid every 30 minutes to prevent dehydration ● meat carbohydrate needs through soft foods custard cream soup gelatin graham crackers 6 to 8 times a day if possible if not consume liquids equal two usual carb content ● test urine for ketones and report to provider if they are outside the expected reference range the level should be negative ● rest

diabetic neuropathy nursing actions and client education

●monitor blood glucose to keep within an acceptable range to slow progression ●provide Foot Care ● encourage annual exams by a podiatrist ● encourage regular follow-up with provider to assess and treat neuropathy

diabetic nephropathy nursing actions client education

●monitor hydration and kidney functions (i&o serum creatinine) ●report an hourly output less than 30 ml per hour ●monitor blood pressure ●encourage yearly urine analysis, bun, microalbumin, serum creatinine ●encourage the client to avoid soda, alcohol, and toxic levels of acetaminophen or NSAIDs. ●Teach the patient to consume 2 to 3 liters per day of fluid from food and beverages with artificial sweetener, and to drink and adequate amount of water ●tell the client to report decrease in output to the provider