Diabetes

Which patient would the nurse plan to teach how to prevent or delay the development of diabetes?

A 34-year-old woman whose parents both have type 2 diabetes

A patient with diabetes is found unconscious at home and a family member called the clinic. After determining that a glucometer is not available, what would the nurse advise the family member to do?

Administer glucagon 1mg intramuscularly or subcutaneously

A patient with diabetes cause the clinic because of nausea and flu like symptoms. What is the nurse is the best advice?

Administer the usual insulin dosage

Which class of oral glucose lowering agents is most commonly used for people with type 2 diabetes, because it reduces hepatic glucose production and enhances tissue uptake of glucose?

Biguanide

The patient with diabetes has a blood glucose level of 248mg/dL. Which assessment findings would be related to this blood glucose level?

Headache, abdominal cramps increase in urination, weakness & fatigue

What would the nurse determine a patient has with a 2-hour OGTT of 152mg/L?

Impaired glucose tolerance

Which instruction would the nurse include when teaching the patient with diabetes about insulin administration?

Consistency use the same size of insulin syringe to avoid dosing errors.

What teaching would be included regarding individualized nutrition therapy for patients using conventional, fixed insulin regimens?

Eat regular meals at regular times

The nurse is assessing a patient newly diagnosed with type one diabetes. Which symptom reported by the patient correlates with the diagnosis?

Excessive thirst

A nurse working in an outpatient clinic plans a screening program for diabetes. What recommendations for screening would be included?

FPG for all persons at age 45 years and then every three years

Which patient statement demonstrates an understanding of the role of exercise in managing diabetes?

My insulin dose may need to change if I have low glucose levels after exercising

What goals of nutrition therapy are included for the patient with type two diabetes

Normal glucose and lipid levels

To prevent hypoglycemia or hyperglycemia related to exercise, what would the nurse teach the patient about exercise when using glucose lowering agents?

Plan activity and food intake related to glucose levels

I'm type 1 diabetes, glucose has an osmotic effect when insulin deficiency prevents the use of glucose for energy. Which symptoms is caused by the osmotic effect of glucose ?

Polydipsia

The nurse is assessing a newly admitted patient with diabetes. Which observation would most concerned the nurse

Rapid, respirations with deep inspiration

The patient with type two diabetes is being prescribed acarbose and wants to know about taking it. What would the nurse include in the patient's teaching?

Take it with the first bite of each meal, effectiveness is measured by two hours postprandial glucose, it delays glucose absorption from the gastrointestinal tract.

What assessment findings occur with diabetic keto acidosis

Thirst, ketonuria, dehydration, metabolic, acidosis, Kussmaul respirations, sweet fruity breath odor

Which are appropriate therapies for patients with diabetes mellitus

Use of statins to reduce CVD risk, use of a ACE or ARB inhibitors to treat neuropathy

A patient with diabetes is learning to mix regular insulin and NPH insulin in the same syringe. The nurse determines the additional teaching is needed when the patient does what?

Withdrawals the NPH dose into the syringe first

What characterizes type 2 diabetes?

beta-cell exhaustion; insulin resistance; genetic predisposition; altered production of adipokines; inherited defect in insulin receptors; inappropriate glucose production by the liver

In addition to promoting the transport of glucose from the blood into the cell, what does insulin do

increases amino acid transport into cells and protein synthesis

A patient with type one diabetes uses 20 U of Novolin 70/30 (NPH/regular) in the morning and at 6:00pm. What would the nurse emphasize when teaching the patient about this regimen?

A set meal pattern with a bedtime snack is necessary to prevent hypoglycemia.

Which treatment plan would the nurse give the highest priority to when caring for a patient with metabolic syndrome?

Achieving a normal weight

During routine health screening, a patient is found to have fasting plasma glucose (FPG) of 132mg/dL (7.33 mmol/L). At a follow-up visit, which laboratory results would a diagnosis of diabetes be made?

A1C of 7.5%, FPG greater or equal to 127mg/dL (7.0mmol/L)

A patient with newly diagnosed type two diabetes has been given a prescription to start an oral hypoglycemic medication, but would rather controller glucose with herbal therapy. What would the nurse do?

Advise the patient to discuss using herbal therapy with her HCP before using it

When would the nurse observe the patient for symptoms of ketoacidosis?

An insulin deficit causes the body to metabolize large amounts of fatty acids rather than glucose for energy

The following interventions are planned for a patient with diabetes which intervention can the nurse delegate to the assistive personnel

Check that the bathwater is not too hot

Lispro insulin (Humalog) with NPH (Humulin N) insulin is ordered for a patient with newly diagnosed type 1 diabetes. When would the nurse administer lispro insulin?

At mealtime or within 15min of meals

What is the priority action for the nurse to take if the patient with type two diabetes reports, headache, nervousness, and dizziness

Check the patient's glucose level

Following the teaching of foot care to a patient with diabetes, the nurse determines that additional instructions is needed when the patient makes which statement

I will know if I have sores or lesions on my feet because they will be painful

The nurse assesses the technique of a patient with diabetes for self blood glucose monitoring three months after initial instruction. Which error in the performance of BGM requires intervention ?

Cleaning the puncture site with alcohol before the puncture

The patient with diabetes has been diagnosed with autonomic neuropathy. What problems with the nurse assess for this patient?

Erectile dysfunction, vomiting undigested food, painless myocardial infarction

What information would the nurse include when teaching the patient with pre diabetes about ways to prevent or delay the development of type 2 diabetes?

Exercise regularly, maintain a healthy weight, monitor for polyuria, polyphagia, and polydipsia

Which laboratory results indicate the patient has pre-diabetes?

Fasting blood glucose result of 120mg/dL (6.7mmol/L)

The patient with type two diabetes has had trouble controlling his glucose with several OAs but wants to avoid the risks of insulin. Which medication will increase insulin synthesis in release from the pancreas, inhibit glucagon secretion, and slow gastric emptying?

Glucagon-like peptide-1 receptor agonist, exenatide extended release

What describes the main difference in treatment for a diabetic keto acidosis and hyperosmolar hyperglycemic syndrome

HHS requires greater fluid replacement to correct the dehydration

72-year-old woman is diagnosed with diabetes. What does the nurse know about managing diabetes in the older adult?

It is harder to achieve strict glucose control than younger patients

Which statement best describes Anthrosclerotic disease affecting the cerebrovascular, cardiovascular, and peripheral vascular systems in patients with diabetes

It occurs with a higher frequency and earlier onset than in the non-diabetic population

A patient taking insulin has recorded fasting glucose levels above 200Mg/dL (11.1mmol/L) for the last five mornings. What would the nurse have the patient do first?

Monitor the glucose level at bedtime between 2 AM and 4 AM and on a rising

When distinguishing between persons with type one diabetes from type two diabetes, the nurse is aware that

Person with type one diabetes requires insulin therapy

Cortisol, glucagon, epinephrine, and growth hormone are referred to as counter regulatory hormones. What do they do?

Stimulate glucose output by the liver

Goals of managing the patient with diabetes include

Teaching self monitoring of glucose levels, preventing complications of hypoglycemia, monitoring for ophthalmologic complications

Two days after self manage hypoglycemic episode at home, the patient tells the nurse that they're glucose level since the episode have been between 80 and 90mg/dL. How would the nurse respond?

That is a good range for your glucose levels

The home care nurse is reviewing insulin administration with a patient. What action by the patient causes the home care nurse to intervene.

The patient mixes an evening dose of regular insulin with insulin glargine in 1 syringe for administration.

When teaching a patient with type 1 diabetes, what would the nurse emphasize as the major advantage of using an insulin pump?

Tight glycemic control can be maintained

You're caring for a patient with newly diagnosed type two diabetes, who was started on metformin. What information should you include in discharge teaching?

Use a portable blood glucose meter

Which tissues require insulin to enable movement of glucose into the tissue cells?

adipose and skeletal muscle

What disorders and diseases are related to macrovascular complications of diabetes?

coronary artery disease, ulceration and amputation of the lower extremities