EAQ's Glucose PP
Which complication associated with type 1 diabetes should the nurse include in the teaching plan for the parent of a newly diagnosed child?
Ketoacidosis
Which molecule excessively accumulated in the blood to precipitate the signs and symptoms associated with a diabetic coma?
Ketones as a result of rapid fat breakdown, causing acidosis.
Which unique response is associated with diabetic ketoacidosis (DKA) that is not exhibited with hyperglycemic hyperosmolar nonketotic syndrome (HHNS)?
Kussmaul respirations
Which adverse effect of metformin will a nurse teach a client with type 2 diabetes to monitor for when used as mono therapy?
Lactic acidosis
For a pregnant client with type 1 diabetes, which action is most likely to reduce the risks of disease-related complications?
Monitor and control blood glucose levels.
For which reason may insulin requirements of a client with type 1 diabetes decrease during the first trimester?
Morning sickness may result in decreased food intake.
Which time range would a nurse teach as the highest risk for hypoglycemia to a client with type 1 diabetes who self-administers neutral protamine Hagedorn (NPH) insulin every morning at 8:00 AM?
Noon to 8:00 PM
The nurse is planning an evening snack for a child receiving NPH insulin. The nurse offers a snack for which reason?
Nourishment helps counteract late insulin activity.
Which statement would a nurse make about older adults and type 2 diabetes?
Older adults seldom develop ketoacidosis.
For which condition is an oral hypoglycemic agent indicated?
Reduced insulin production
Which eye problem is the leading cause of blindness in clients with diabetes?
Retinopathy
Which hormone would the nurse identify as inhibiting insulin and glucagon secretion?
Somatostatin
Which mechanism of action explains how glyburide decreases serum glucose levels?
Stimulates the pancreas to produce insulin
When planning care for a client with type 1 diabetes, which change in insulin requirements would the nurse anticipate on the first postpartum day?
Sudden decrease
A client with type 1 diabetes has dry, hot, flushed skin; a fruity odor to the breath; and is having a kussmaul respirations. Which complication does the nurse suspect that the client is experiencing?
Ketoacidosis
An increase in which blood component is responsible for the acidosis related to untreated diabetes mellitus?
Ketones
Which information would the nurse include in a teaching plan when teaching a client with diabetes about the advantages of using an insulin pump?
It can improve A1c levels. Clients may be able to exercise without eating more carbohydrates.
Which explanation would the nurse share regarding the reversal of hypoglycemia after administering a tube of glucose gel to a client?
It provides a glucose source that is rapidly absorbed.
Between which weeks of gestation would a client with type 1 diabetes expect to increase her insulin dosage?
24th and 28th weeks of gestation
The primary HCP prescribes daily fasting blood glucose levels for a client with diabetes mellitus. Which is the goal of fasting glucose levels for a client with diabetes mellitus?
70-105 mg/dL (3.9-5.8 mmol/L) of blood.
Which client's needs would the nurse address first?
Client B A1C% - 6.8 Fasting plasma glucose level (mg/dL) - 130 Two hour plasma glucose level (mg/dL) - 200
Which is the priority concern of a 10-year-old child who was recently diagnosed with type 2 diabetes?
How much school might be missed.
Which lab value supports the presence of diabetic ketoacidosis in a client with type 1 diabetes?
Increased blood urea nitrogen levels
A client with diabetes mellitus complains of difficulty seeing. Which factor would the nurse suspect as being the cause?
The growth of new retina blood vessels or "neovascularization"
Which medication is responsible for neonatal hypoglycemia?
Tolbutamide
The nurse teaches a client with type 2 diabetes how to provide self-care to prevent infections of the feet. Which statement made by the client shows that teaching was effective?
"I should control my blood glucose with diet, exercise, and medication."
Which instruction will the nurse provide to a client with type 2 diabetes who develops gout when teaching about the administration of allopurinol?
"Monitor blood glucose levels more frequently."
Which initial response would the nurse make to a 67-year-old man with type 2 diabetes who sadly confides in the nurse that he has been unable to have an erection for several years?
'You sound upset about not being able to have an erection.'
Which statement will the nurse consider when developing the teaching plan for a client with type 2 diabetes prescribed oral hypoglycemic medication?
Clients taking oral hypoglycemics may subconsciously relax dietary rules to gain a sense of control.
Which purpose is served by an evening snack of milk, crackers, and cheese for a client who is receiving NPH insulin?
Food to counteract late insulin activity
An adolescent with type 1 diabetes mellitus is admitted to the ICU in ketoacidosis with a blood glucose level of 170 mg/dL. A continuous insulin infusion is started. Which adverse reaction to the infusion is most important for the nurse to monitor?
Hypokalemia
Which lab value supports the presence of diabetic ketoacidosis?
Increased serum lipids
When obtaining the history of a client recently diagnosed with type 1 diabetes, which symptom would the nurse expect to see?
Weight loss
Which response will the nurse provide to a client with type 2 diabetes taking one glyburide tablet daily who asks whether an extra tablet should be taken before exercise?
"Do not take an extra pill because you may become hypoglycemic when exercising."
Which statement made by a client prescribed metoformin extended release to control type 2 diabetes mellitus indicates the need for further education?
"I will stop taking metformin for 24 hours before and after having a test involving dye."
The nurse is assessing a client admitted with diabetic ketoacidosis. Which statement made by the client indicated a need for further education on sick day management?
"I will stop taking my insulin when I am I'll because I am not eating."
How will the nurse respond to a client with a new diagnosis of type 1 diabetes who becomes agitated and says, "I am scared of shots. If that is my only option, I'll just have to go into a coma and die!" when told that lifelong insulin will be needed?
"Injections are not the only option available for insulin."
Which response would a nurse give to a client who asks "Why can't I take the insulin in pills instead of taking shots?" during a teaching session about insulin injections?
"Insulin is destroyed by gastric juices, rendering it ineffective."
A child is prescribed insulin glargine before breakfast. Which instruction is most appropriate for the nurse to give the parent regarding a bedtime snack?
"Offer a snack to prevent hypoglycemia during the night."
Which information would the nurse include when teaching a type 2 diabetic controlled with oral anti diabetic medications who is prescribed regular insulin when admitted for elective surgery?
"With insulin, dosage can be adjusted to your changing needs during recovery from surgery."
A mother asks the neonatal nurse why her infant must be monitored so closely hypoglycemia when her type 1 diabetes was in excellent control during the entire pregnancy. How would the nurse best respond?
'Babies of mothers with diabetes have a higher-than-average insulin level because of the excess glucose received from the mother during pregnancy, so the glucose level may drop'
A mother asks the neonatal nurse why her infant must be monitored so closely for hypoglycemia when her type 1 diabetes was in excellent control during the entire pregnancy. How would the nurse best respond?
'Babies of mothers with diabetes have a higher-than-average insulin level because of the excess glucose received from the mother during pregnancy, so the glucose level may drop.'
The nurse is teaching a 12-year-old child about the action of insulin injections. Which statement indicates the child understands how insulin works in the body?
'Glucose carried into cells where it is used for energy.'
Self-administer injections with an insulin pen
- Prime the needle with two units - Use a 29-gauge insulin needle -Refrain from recapping the needle -Dial the pen to deliver the unit dose -Give the injection at a 45-degree angle
The nurse is educating the client newly diagnosed with type 2 diabetes on oral anti diabetic medications. Which instruction would the nurse include in the teaching plan?
1. The client should obtain a finger-stick blood glucose reading before each meal. 2. The teaching plan should include signs and symptoms of hypoglycemia. 3. The teaching plan should include sick day rules.
The nurse teaches an adolescent with type 1 diabetes about peak action of NPH insulin and the risk for hypoglycemia. The nurse determines teaching has been effective when the adolescent identifies insulin peak action within which time frame?
4-12 hours
When will the nurse monitor for potential hypoglycemic reaction after administering daily regular insulin to a client with type 1 diabetes at 8 AM?
Before lunch
While obtaining a client's health history, which factor would the nurse identify as predisposing the client to type 2 diabetes?
Being 20 pounds overweight
Which lab results support the nurse's suspicion that a client diagnosed with type 1 diabetes is experiencing ketoacidosis?
Blood glucose of 300 mg/100 Mallory (16.7 mmol/L), blood pH of 7.20
Which physiological changes would the nurse expect to find in a client with a 20-year history of type 2 diabetes?
Blurry, spotty, or hazy vision
Which child would the nurse recommend screening for type 2 diabetes mellitus (T2DM) during a local health screening?
Child who recently turned 10 years old, has not yet entered puberty, and has no other risk factors. African American child, BMI in the 87th percentile, family history of diabetes. Caucasian child, BMI in the 96th percentile, signs of insulin resistance.
Upon assessment, the nurse finds the client is experiencing weight gain as well as elevated lipid and blood glucose levels. Which medication on the client's prescription list is most likely to cause these metabolic side effects?
Clozapine Olanzapine
A client experiences ineffective control of type 1 diabetes. The client's study results indicate that a sudden decrease in blood glucose level is followed by rebound hyperglycemia. When this event occurs, which action would the nurse take?
Collaborate with the primary HCP to alter the insulin prescription.
When determining the main difference between type 1 and type 2 diabetes, the nurse recognizes which clinical presentation about type 1?
Complications are not present at the time of diagnosis.
Which finding would lead the nurse to recheck the blood glucose level of diabetic client before administering a mealtime insulin dose?
Confusion Drowsiness Diaphoresis Nervousness Heart rate 100 beats/min
Which manifestation would the nurse include when teaching a client about ketoacidosis?
Confusion Excessive thirst Fruity-scented breath
Which cellular process associated with type 1 diabetes mellitus results in increased client fatigue?
Decreased production of insulin by the pancreas.
Which clinical finding supports the diagnosis of diabetic ketoacidosis (DKA)?
Deep respirations and fruity odor breath
A client's breath has a sweet,fruity odor. Which condition is affecting this client?
Diabetic acidosis
The nurse is assessing a client with diabetic ketoacidosis. Which clinical manifestations would the nurse expect?
Dry skin Abdominal pain Kussmaul respirations
A client is taught how to recognize signs of a hypoglycemic reaction. Which symptoms identified by the client indicate to the nurse that the teaching was effective?
Fatigue Weakness Nervousness Increased perspiration
A student with type 1 diabetes asks the nurse which primary hormone causes the blood glucose level to ride. Which hormone would the nurse report?
Glucagon
Which medication would be administered to a client who reports sweating, tachycardia, and tremors with a laboratory report that reveals serum cortisol less than normal and blood glucose level of 60 mg/dL?
Glucagon
The nurse is caring for a client with hypoglycemia. The nurse anticipates a prescription for which medications?
Glucagon IV glucose Oral hydrocortisone
Which lab test would the nurse expect to be prescribed that will reveal the effectiveness of a diabetic regimen for a child with type 1 diabetes?
Glycosylated hemoglobin
Which condition would the nurse identify as the likely cause of profound weakness and nervousness in a client that became confused shortly after self-administering the morning dose of 10 units of regular insulin and 25 units of NPH insulin after a light breakfast with no additional intake in the 3 hours since that time?
Hypoglycemia
With which condition would the nurse associate the response of diaphoresis, weakness, and valor at 3:30 PM in a client with type 1 diabetes who receives 30 units of neutral protamine Hagedorn (NPH) insulin at 7:00 AM?
Hypoglycemic reaction
Which initial intervention would the nurse expect the primary HCP to order for a client admitted to the hospital with a diagnosis of diabetic ketoacidosis?
IV fluids
Why is 15 g of simple sugar administered when a client with diabetes experiences hypoglycemia?
Increases blood glucose levels
An adolescent with a history of type 1 diabetes is admitted ketoacidosis. Which cause would the nurse suspect as precipitating the episode of ketoacidosis?
Infection
Which insulin will the nurse prepare for the emergency treatment of ketoacidosis?
Insulin aspart
Which insulin would the nurse conclude has the fastest onset of action?
Insulin lispro
Which information will the nurse include when teaching a client with type 1 diabetes about the use of an insulin pump?
Insulin pumps mimic the way a healthy pancreas works.
A 15-year-old adolescent is found to have type 1 diabetes. Which would the nurse include when teaching the adolescent about type 1 diabetes?
It has a more rapid onset than does type 2 diabetes.
Which complication of diabetes would the nurse assess for in a client with a long history of the disease?
Leg ulcers Loss of visual acuity Prolonged capillary refill in the toes Decreased sensation in the lower extremities
A client with type 1 diabetes for 25 years states, "I have been really bad for the past 15 years. I have not paid attention to my diet and have done little to control my diabetes." Which common complications of diabetes might the nurse expect to identify when assessing this client?
Leg ulcers Loss of visual acuity Thick,yellow toenails Decreased sensation in the feet
Which condition would cause a contender 5-cm indurated region on the upper arm of a client with type 1 diabetes who says to the nurse, "That is where I give myself insulin shots." ?
Lipodystrophy
The nurse is teaching a client newly diagnosed with type 1 diabetes about self-care. Which is the primary long-term goal?
Maintaining normoglycemia
Which results would the nurse expect to find when assessing the lab values of a client with type 2 diabetes?
Urine negative for ketones and positive glucose in the blood
Which education would the nurse provide the parents of a child with type 1 diabetes who ask why they should test the child's urine for ketones during periods of stress or illness, even though blood glucose testing is being done four times a day?
Urine should be tested for ketones during illness and when the blood glucose level is increased.
Which advice will the nurse provide to a client who is taking an oral hypoglycemic daily for type 2 diabetes who develops an infection with anorexia?
-Continue to take the oral medication -Drink fluids throughout the day -Monitor capillary glucose levels
Which complication of diabetes would the nurse suspect when a health care provider prescribes one tube of glucose gel for a client with type 1 diabetes?
Insulin-induced hypoglycemia
When determining the the main difference between type 1 and type 2 diabetes, the nurse recognizes which clinical presentation about type 1?
Complications are not present at the time of diagnosis.
A continuous insulin infusion is started on an adolescent with a blood glucose level of 700 mg/dL (38.9 mmol/L). Which complication would the nurse make a priority of detecting while the adolescent is receiving the infusion?
Hypokalemia
Which assessment finding would the nurse associate with a client with diabetic ketoacidosis?
Acetone breath Decreased arterial carbon dioxide level
Which action would be taken by the nurse caring for a client with type 1 diabetes mellitus who has a finger-stick glucose level of 258 mg/dL at bedtime and a prescription for sliding-scale regular insulin?
Administer the insulin as prescribed.
Which cause of tremors, pallor, and diaphoresis would be suspected in a client with type 1 diabetes?
Aerobic exercise
Which factors can predispose a client with type 1 diabetes to a diabetic ketoacidotic coma?
Excessive emotional stress Running a fever with the flu
Which type of insulin would the nurse recognize as compatible with IV solutions when caring for a client with diabetes mellitus who is scheduled to receive an IV administration of 25 units of insulin in 250 mL normal saline?
Insulin lispro
The nurse is explaining insulin needs to a client with gestational diabetes who is in her second trimester of pregnancy. Which information would the nurse give to this client?
Insulin needs will increase during the second trimester
The lab findings of an obese hypertensive adolescent reveal hyperinsulinemia and dyslipidemia. Which condition would the nurse anticipate incorporating into the plan of care?
Insulin resistance syndrome
Which responses would the nurse expect a client experiencing hypoglycemia to exhibit?
Palpitations Tachycardia Nervousness
The nurse plans to teach a school-aged child with type 1 diabetes who is receiving both intermediate-acting insulin and regular insulin daily how to self-administer the insulin before discharge. Which procedure would the nurse teach the child?
Practice using the nondedicated insulin pen first.
Which common cause of diabetic ketoacidosis would the nurse consider when caring for a postoperative client with diabetes?
Presence of infection.
Which newborn would the nurse anticipate will experience hypoglycemia?
Preterm infant Small-for-gestational-age infant Large-for-gestational-age infant
Which rationale explains why IV potassium is prescribed in addition to regular insulin for clients with diabetic ketosis?
Serum potassium levels will decrease as potassium ions shift from the extracellular fluid to the intracellular fluid compartment.
When teaching a client with diabetes about monitoring episodes of hypoglycemia, which symptom would the nurse include in the teaching plan?
Sweating
Which fluid shift will the nurse take into consideration when assessing a client with type 1 diabetes who is experiencing a fluid imbalance?
Intercellular to intravascular as a result of hyperosmolarity.
