Maternal NB SR

Which finding would lead the nurse to recheck the blood of a diabetic client before administering a mealtime insulin dose? a. confusion b.drowsiness c. diaphoresis d. nervousness e. heart rate 110 beats/min

a,b,c,d,e

Which responses indicate that the client receiving total parenteral nutrition is experiencing hyperglycemia? a. polyuria b. polydipsia c. paralytic ileus d. respiratory rate of 26 breaths/min e. serum glucose of 105 mg/dL

a,b,d Glucose that is being filtered in the kidney acts as an osmotic diuretic; glycosuria promotes polyuria. Polydipsia and fluid intake are the responses to excess fluid loss related to osmotic diuresis. With hyperglycemia, there may be hyperventilation in an attempt to blow off carbon dioxide if ketones are produced;24 breaths per min is characteristic of hyperventilation. Paralytic ileus is not associated with hyperglycemia.

Which instruction would the nurse provide to a 6'0", 160-pound client newly diagnosed with type 1 diabetes who wants to self-administer injections with an insulin pen? a. prime the needle with 2 units b. use a 29-guage insulin needle c. give the injection at 45 degree angle d. refrain from recapping the needle e. Dial the pen to deliver the unit dose.

a,b,c,d,e

Which mechanism of action explains how glyburide decreases serum glucose levels? a. stimulates the pancreas to produce insulin. b. accelerates the liver's release of stored glycogen c. Increases glucose transport across the cell membrane. d. Decrease absorption of glucose from the GI system .

a.

Why is blood glucose self-monitoring preferred over urine glucose testing? a. blood glucose monitoring is more accurate. b. blood glucose monitoring is easier to perform c. blood glucose monitoring is done by the client d. blood glucose monitoring is not influenced by medications.

a.

Which chemical buffers excessive acetoacetic acid? a. Potassium b. sodium bicarbonate c. carbon dioxide d. sodium chloride

b.

Between which weeks of gestation would a client with type 1 diabetes expect to increase her insulin dosage? a.10th and 12th weeks of gestation b. 18th and 22nd weeks of gestation c. 24th and 28th weeks of gestation d. 36th and 40th weeks of gestation

c. At the end of the second trimester and the beginning of the third trimester, insulin needs increase because of an increase in maternal resistance to insulin. During the earlier part of pregnancy, fetal demands for maternal glucose may cause a tendency toward hypoglycemia. During the last weeks of pregnancy, maternal resistance to insulin decreases, and insulin needs decrease accordingly.

Which sign or symptom would the nurse expect to find on assessment of a client with a blood glucose level of 55 mg/dL a. increased thirst b. abdominal pain c. frequent urination d. cold clammy skin e. 3 + glucose in urinalysis

d

Before having surgery, a client with type 1 diabetes insulin requirements are elevated but well controlled. Which insulin requirements would the nurse anticipate for this client postoperatively? a. decrease b. fluctuate c. increase sharply d. remain elevated

d Emotional and physical stress may cause insulin requirement to remain elevated in the postoperative period. Insulin requirements will remain elevated rather than decrease. Fluctuating insulin requirements usually associated with noncompliance, not surgery. A sharp increase in the clients insulin requirements may indicate sepsis, but this is not expected.

A child with type 1 diabetes is exhibiting deep, rapid respirations; flushed, dry cheeks; abdominal pain with nausea; and increased thirst. Which blood pH and glucose level would the nurse expect the lab tests to reveal? a. 7.20 and 60 mg/dL b. 7.50 and 60 mg/dL c. 7.50 and 460 mg/dL d. 7.20 and 460 mg/dL

d. 7.20 and 460 mg/dL

The nurse is planning an evening snack for a child receiving NPH insulin. The nurse offers a snack for which reason? a. It encourages the child to stay on the diet. b. energy is needed for immediate utilization c. extra calories will help the child gain weight d. nourishment helps counteract later insulin activity

d. A bedtime snack is needed for the evening. NPH insulin is intermediate-acting insulin, which peaks 4-12 hours later and last for 18-24 hours. Protein and carb ingestion before sleep prevents hypoglycemia during the night when the NPH is still active. The snack is important for diet-insulin balance during the night, not encouragement. There are no data to indicate that extra calories needed; at bedtime snack is routinely provided to help cover intermediate-acting insulin during sleep. The snack must contain mainly protein-rich foods, not simple carbohydrates, to help cover the intermediate-acting insulin during sleep.

Which is a gastrointestinal manifestation of infection in the newborn? a. lethargy b. irritability c. nasal flaring d. poor perfusion e. glucose instability

e. Glucose instability is a GI manifestation of newborn infection Lethargy and irritability are central nervous systems changes associated with infection. Nasal flaring is a respiratory manifestation of infection. Poor perfusion is a cardiovascular manifestation of infection.

Which finding is indicative of hypothermia in a newborn? a. seizures b. diaphoresis c. flushed skin d. poor feeding e. hypoglycemia

e. Hypoglycemia in a newborn can indicate hypothermia or cold stress. Seizures, diaphoresis, flushed skin, and poor feeding are indicative of hyperthermia.

Which information would the nurse base a response to a mother who asks for guidance regarding who to tell of the diagnosis of diabetes of her child, who plays on the soccer team? a. children with diabetes who participate in active sports can have episodes of hypoglycemia b. children may have to leave athletic teams if school authorities learn that they have diabetes. c. the school nurse will treat the child of clinical findings of hypoglycemia recognized early. d. the coach might violate confidentiality by discussing the child's conditions with other faculty memeber.

a.