saunders diabetes mellitus

A client is in metabolic acidosis caused by diabetic ketoacidosis (DKA). The nurse prepares for the administration of which medication as a primary treatment for this problem?

Regular insulin

The nurse reviews the nursing care plan of an older client with diabetic neuropathy of the lower extremities as a result of type 2 diabetes mellitus. The nurse plans care knowing that which problem has the highest priority for this client?

The possibility of injury as a result of decreased sensation in the legs and feet

The nurse realizes that the client taking metformin needs further teaching when the client makes which statement?

should treat hypoglycemic episodes due to metformin with glucose tablets only."

The nurse has collected data on a client with diabetes mellitus. Findings include a fasting blood glucose of 130 mg/dL, temperature 101° F, pulse of 88 beats per minute, respirations of 22 breaths per minute, and a blood pressure of 118/78 mm Hg. Which finding would be of concern to the nurse?

temperature

A client is brought to the emergency department with suspected diabetic ketoacidosis (DKA). Which finding would the nurse note as being consistent with this diagnosis?

High serum glucose level and low serum bicarbonate level

A client with diabetes mellitus decides to exercise an extra 30 minutes. The client is now experiencing hypoglycemia. Hypoglycemia is supported by which noted data? Select all that apply.

Hunger Shakiness Cool, clammy skin

A client newly diagnosed with diabetes mellitus takes NPH insulin every day at 7:00 am. The nurse has taught the client how to recognize the signs of hypoglycemia. The nurse determines that the client understands the information presented if the client watches for which signs and symptoms in the late afternoon?

Hunger; shakiness; and cool, clammy skin

A client is admitted to the hospital with a diagnosis of diabetic ketoacidosis (DKA). The initial serum glucose level was 950 mg/dL. Intravenous (IV) insulin was started along with rehydration with IV normal saline. The serum glucose level is now 240 mg/dL. The nurse who is assisting in caring for the client obtains which item anticipating a primary health care provider's prescription?

IV infusion containing 5% dextrose

The nurse is providing instructions to a client newly diagnosed with diabetes mellitus. The nurse gives the client a list of the signs of hyperglycemia. Which specific signs of this complication would be included on the list?

Increased thirst

The nurse is reinforcing instructions to a client newly diagnosed with diabetes mellitus regarding insulin administration. The primary health care provider has prescribed a mixture of NPH and regular insulin. The nurse would stress that which is the first step?

Inject air equal to the amount of NPH insulin prescribed into the vial of NPH insulin.

The nurse is planning to instruct a client with diabetes mellitus who has hypertension about "sick day management." Which beverage does the nurse avoid putting on a list of easily consumed carbohydrate-containing beverages for use when the client cannot tolerate food orally?

Mineral water

The nurse is monitoring the results of periodic serum laboratory studies drawn on a client with diabetic ketoacidosis (DKA) receiving an insulin infusion. The nurse determines that which value needs to be reported?

Potassium 3.1 mEq/L

The nurse is caring for a client with type 1 diabetes mellitus who is hyperglycemic. Which problem would the nurse consider first when planning care for this client?

Signs of dehydration

The nurse reinforces teaching to a client with diabetes mellitus regarding differentiating between hypoglycemia and ketoacidosis. The client demonstrates an understanding of the teaching by stating that glucose will be taken if which symptom develops?

Shakiness

A client with diabetes mellitus who takes insulin is seen in the health care clinic. The client tells the nurse that after giving the injection, the insulin seems to leak through the skin. The nurse can appropriately determine the problem by asking the client which?

"Are you rotating the injection site?"

The nurse is monitoring a client who has been newly diagnosed with diabetes mellitus for signs of complications. Which statement made by the client would indicate hyperglycemia and thus warrant primary health care provider (PHCP) notification?

"I am urinating a lot."

A client with type 1 diabetes mellitus takes NPH insulin every morning and checks the blood glucose level four times per day. The client tells the nurse that yesterday the late afternoon blood glucose was 60 mg/dL and that she "felt funny." Which statement by the client indicates an understanding of this occurrence?

"I forgot to take my usual mid-afternoon snack yesterday."

The nurse provides dietary instructions to a client with diabetes mellitus regarding the prescribed diabetic diet. Which statement made by the client indicates the need for further teaching?

"I need to buy special dietetic foods."

The nurse is assigned to care for a client at home who has a diagnosis of type 1 diabetes mellitus. When the nurse arrives to care for the client, the client tells the nurse that she has been vomiting and has diarrhea. Which additional statement by the client indicates a need for further teaching?

"I need to stop my insulin."

The nurse has reinforced instructions about measuring blood glucose levels to a client newly diagnosed with diabetes mellitus. The nurse determines that the client understands the procedure when making which most accurate statement?

"I should check my blood glucose level before eating each meal regardless of how much I eat."

The nurse has reinforced home care measures to a client diagnosed with diabetes mellitus regarding exercise and insulin administration. Which statement by the client indicates a need for further teaching?

"I should perform my exercise at peak insulin time."

The nurse in an outpatient diabetes clinic is assisting in caring for a client on insulin pump therapy. Which statement by the client indicates a need for further teaching regarding insulin pump therapy?

"Now that I have this pump, I don't have to worry about insulin reactions or ketoacidosis occurring again."

The nurse is caring for a client newly diagnosed with diabetes mellitus. The client asks the nurse whether eating at a restaurant will affect the diabetic control and whether this is allowed. Which nursing response is appropriate?

"You should order a half-portion meal and have fresh fruit for dessert."

A hospitalized client is newly diagnosed with diabetes mellitus. The client must take both NPH and regular insulin for glucose control. The nurse develops a teaching plan to help the client meet which outcome as a first step in managing the disease?

Adjust insulin according to capillary blood glucose levels.

The nurse is assigned to assist in caring for a client admitted to the emergency department with diabetic ketoacidosis (DKA). Which is the priority nursing action for this client who is in the acute phase?

Administer intravenous (IV) regular insulin.

A client receiving desmopressin begins to complain of a headache. The nurse notes that the client is listless and falls asleep easily. The nurse interprets that the client is most likely experiencing which reaction?

Adverse medication effects

The nurse is reviewing the prescriptions of a client diagnosed with diabetes mellitus who was admitted because of an infected foot ulcer. Which primary health care provider's prescription supports the treatment of this condition?

An increased amount of NPH daily insulin

The nurse is assisting with preparing a teaching plan for the client with diabetes mellitus regarding proper foot care. Which instruction would be included in the plan of care?

Apply a moisturizing lotion to dry feet, but not between the toes.

The nurse participating in a free health screening at the local mall obtains a random blood glucose level of 200 mg/dL on an otherwise healthy client. The nurse tells the client to do which as a next step?

Call the primary health care provider to have the value rechecked as soon as possible.

The wife of a client with diabetes mellitus who takes insulin calls the nurse in a primary health care provider's office about her husband. She states that her husband is sleepy and that his skin is warm and flushed. She adds that his breathing is faster than normal and his pulse rate seems fast. Which action would the nurse tell the wife to do first?

Check his blood glucose level.

A client with a diagnosis of diabetic ketoacidosis (DKA) is being treated in the emergency department. Which finding would the nurse expect to note as confirming this diagnosis?

Elevated blood glucose and low plasma bicarbonate

The nurse is assisting in preparing a plan of care for a client with diabetes mellitus and plans to reinforce the client's understanding regarding the signs/symptoms of hypoglycemia. Which signs/symptoms would the nurse review?

Elevated pulse; shakiness; and cool, clammy skin

After several diagnostic tests, a client is diagnosed with diabetes insipidus. The nurse understands that which signs/symptoms are indicative of this disorder?

Excessive thirst and urine output

A comatose client with an admitting diagnosis of diabetic ketoacidosis (DKA) has a blood glucose value of 368 mg/dL, arterial pH of 7.2, arterial bicarbonate of 14 mEq/L, and is positive for serum ketones. The diagnosis is supported by which noted data? Select all that apply.

Fruity breath odor Rapid, deep breathing Dry mucous membranes

A client with type 2 diabetes mellitus has a blood glucose of more than 600 mg/dL and is complaining of polydipsia, polyuria, weight loss, and weakness. The nurse reviews the primary health care provider's documentation and would expect to note which diagnosis?

Hyperglycemic hyperosmolar state (HHS

A client newly diagnosed with diabetes mellitus is instructed by the primary health care provider to obtain glucagon hydrochloride for emergency home use. The client asks the nurse about the purpose of the medication. The nurse tells the client that the purpose of the medication is to treat which aspect of diabetes?

Hypoglycemia from insulin overdose

A client with type 1 diabetes mellitus calls the nurse to report recurrent episodes of hypoglycemia. Which statement by the client indicates a correct understanding of Humulin N insulin and exercise?

I should not exercise in the late afternoon."

A client is brought to the emergency department in an unresponsive state, and a diagnosis of hyperglycemic hyperosmolar state (HHS) is made. The nurse who is assisting with care for the client obtains which item in preparation for the treatment of this syndrome?

Intravenous (IV) infusion of normal saline

A client recently diagnosed with diabetes mellitus requiring insulin tells the clinic nurse that he is traveling by air throughout the next week. The client asks the nurse for any suggestions about managing the disorder while traveling. Which action would the nurse tell the client to do?

Keep snacks in carry-on luggage to prevent hypoglycemia during the flight.

The nurse is reinforcing instructions to a client with diabetes mellitus about blood glucose monitoring and monitoring for signs of hypoglycemia. The nurse would teach the client that which result is a sign of hypoglycemia?

Less than 50 mg/dL

A client newly diagnosed with diabetes mellitus is having difficulty learning the technique of blood glucose measurement. The nurse would teach the client to do which action to perform the procedure properly?

Let the arm hang dependently and milk the digit.

The nurse is reinforcing instructions to a client with diabetes mellitus who is recovering from diabetic ketoacidosis (DKA) regarding measures to prevent a recurrence. Which instruction is important for the nurse to emphasize

Monitor blood glucose level frequently.

Which instruction would the nurse reinforce to the client with diabetes mellitus receiving acarbose? Select all that apply.

Take the medication with each meal." take some form of glucose if hypoglycemia occurs. Side effects include abdominal bloating and flatus." "Report symptoms such as shortness of breath or tiredness."

The nurse is collecting data from a client newly diagnosed with diabetes mellitus regarding the client's learning readiness. Which client behavior indicates to the nurse that the client is not ready to learn?

The client complains of fatigue whenever the nurse plans a teaching session.

A client with diabetes mellitus is being discharged following treatment for hyperglycemic hyperosmolar state (HHS) precipitated by acute illness. The client states to the nurse, "I will call the doctor next time I can't eat for more than a day or so." The nurse plans care understanding that which statement accurately reflects this client's level of knowledge?

The client needs immediate education before discharge.

The primary health care provider (PHCP) prescribes exenatide for a client with type 1 diabetes mellitus who takes insulin. The nurse knows that which is the most appropriate intervention?

The medication is withheld, and the PHCP is called to question the prescription for the client.

The nurse is collecting data from a client with type 2 diabetes mellitus. Which statement by the client indicates an understanding of the medication regimen?

The medication that I am taking helps release the insulin I already make."

The nurse is discussing foot care with a diabetic client and the spouse. The nurse includes which instruction during this informational session?

The toenails should be cut straight across.

Which client complaint would alert the nurse to a possible hypoglycemic reaction?

Tremors and double vision

Glucagon hydrochloride injection would most likely be prescribed for which disorder?

Type 1 diabetes mellitus

A client with diabetes mellitus is scheduled to have a fasting blood glucose level determined in the morning. The nurse tells the client not to eat or drink after midnight. When the client asks for further information, the nurse clarifies by stating that which would be acceptable to take before the test?

Water

When the nurse is reinforcing instructions to a client who has been newly diagnosed with type 1 diabetes mellitus, which statement by the client would indicate that teaching has been effective?

"I will notify my primary health care provider (PHCP) if my blood glucose level is consistently greater than 250."

the client plans to give his lispro insulin injection at 0800 right before eating breakfast. The nurse knows that the client understood the education provided when the client states which time presents the greatest risk for hypoglycemia?

0930

The nurse has just supervised a client who has newly diagnosed diabetes mellitus self-inject NPH insulin at 7:30 am. The nurse reviews the time frames for peak insulin action with the client, telling the client to be especially watchful for a hypoglycemic reaction during which time frame?

1:30 pm and 7:30 pm

A client with diabetes mellitus demonstrates acute anxiety when admitted to the hospital for the treatment of hyperglycemia. Which intervention would be appropriate to decrease the client's anxiety?

Convey empathy, trust, and respect toward the client.

The nurse has provided diabetic teaching with the family of a client newly diagnosed with diabetes. The nurse determines that the family understands the reason for having glucagon on hand for emergency home use if the family indicates that the purpose of the medication is to treat which condition?

Hypoglycemia from insulin overdose

Potassium iodide is prescribed for a client. The client calls the nurse at the clinic and complains of a brassy taste and burning sensations in the mouth. How would the nurse respond?

Notify the primary health care provider.

The nurse notes that a client with type 1 diabetes mellitus has lipodystrophy on both upper thighs. Which further information would the nurse obtain from the client during data collection?

Plan for injection rotation

The nurse is caring for a client newly diagnosed with type 1 diabetes mellitus. In reviewing the medical record the nurse would note which signs and symptoms? Select all that apply.

Polyphagia Extreme thirst Rapid weight loss

A client who has been newly diagnosed with diabetes mellitus has been stabilized with daily insulin injections. Which teaching information would the nurse reinforce upon discharge?

Rotate the insulin injection sites systematically.

A client with type 1 diabetes mellitus is to begin an exercise program, and the nurse is reinforcing instructions to the client regarding the program. Which instruction would the nurse include?

Take a blood glucose test before exercising.

The nurse is reinforcing dietary instructions to a client newly diagnosed with diabetes mellitus. The nurse accurately instructs the client with which statement?

It is best to eat meals at approximately the same time each day.

A client with diabetes mellitus visits the health care clinic. The client previously had been well controlled with glyburide, but recently the fasting blood glucose has been running 180 to 200 mg/dL. Which medication, if added to the client's regimen, may be contributing to the hyperglycemia?

Prednisone

The nurse enters the room of a client with type 1 diabetes mellitus and finds the client difficult to arouse. The client's skin is warm and flushed, and the pulse and respiratory rate are elevated from the client's baseline. Which action would the nurse implement?

Check the client's capillary blood glucose.

The nurse is assisting in preparing a care plan for a client with diabetes mellitus who has hyperglycemia. The nurse would focus on which potential problem for this client?

Dehydration

A client who is managing diabetes mellitus with insulin injections asks the nurse for information about any necessary changes in her diet to avoid hyperinsulinism. Which diet would be appropriate for the client?

Small frequent meals with protein, fat, and carbohydrates at each meal

A client with hypoparathyroidism has hypocalcemia. The nurse avoids giving the client the prescribed vitamin and calcium supplement with which liquid?

milk