70 Neuro and 51 Diabetes

they increase the need for insulin

A client with diabetes mellitus develops sinusitis and otitis media accompanied by a temperature of 100.8° F (38.2° C). What effect do these findings have on his need for insulin?

administer glucose

A client with diabetic ketoacidosis has been brought into the ED. Which intervention is not a goal in the initial medical treatment of diabetic ketoacidosis?

underlying problem of insulin resistance

A client with type 2 diabetes asks the nurse why he can't have a pancreatic transplant. Which of the following would the nurse include as a possible reason?

switch pt to a different oral antidiabetic agent

After taking glipizide (Glucotrol) for 9 months, a client experiences secondary failure. What should the nurse expect the physician to do?

3 months

Glycosylated hemoglobin reflects blood glucose concentrations over which period of time?

Impaired sensory perception

The nurse is providing discharge teaching to a client with a spinal cord tumor and instructs the client to avoid hot water bottles and heating blankets for what reason?

hypoglycemia

When the nurse is caring for a patient with type 1 diabetes, what clinical manifestation would be a priority to closely monitor?

Fruity breath

Which assessment finding is most important in determining nursing care for a client with diabetes mellitus?

Weight loss

Which factor is the focus of nutrition intervention for clients with type 2 diabetes?

High sugar pulls fluid into the bloodstream, which results in more urine production.

Which is the best nursing explanation for the symptom of polyuria in a client with diabetes mellitus?

Glargine (Lantus)

Which of the following insulins are used for basal dosage?

Begin fluid replacements.

A child is brought into the emergency department with vomiting, drowsiness, and blowing respirations. The father reports that the symptoms have been progressing throughout the day. The nurse suspects diabetic ketoacidosis (DKA). Which action should the nurse take first in the management of DKA?

Subarachnoid space

A client diagnosed with a malignant brain tumor is scheduled to receive chemotherapy intrathecally. When explaining this technique to the client, the nurse would describe the medication as being injected into which area?

glycosylated hemoglobin level

During a follow-up visit 3 months after a new diagnosis of type 2 diabetes, a client reports exercising and following a reduced-calorie diet. Assessment reveals that the client has only lost 1 pound and did not bring the glucose-monitoring record. Which value should the nurse measure?

Increased urine osmolarity

For a client with hyperglycemia, which assessment finding best supports a nursing diagnosis of Deficient fluid volume?

Cool, clammy skin; jugular vein distention; and a decreased serum sodium level

are signs of fluid volume excess (hypervolemia)

7:45

A client is receiving insulin lispro at 7:30 AM. The nurse ensures that the client has breakfast by which time?

rapid, thready pulses

A client who was diagnosed with type 1 diabetes 14 years ago is admitted to the medical-surgical unit with abdominal pain. On admission, the client's blood glucose level is 470 mg/dl. Which finding is most likely to accompany this blood glucose level?

3500 per week

A female patient with diabetes who weighs 150 pounds has an ideal body weight of 118 pounds. She can lose 1 pound per week and drop her extra 32 pounds in approximately 8 months. To meet this goal, the nurse advises the patient to decrease her calories by:

the short acting insulin is withdrawn before the intermediate-acting insulin.

A nurse is preparing to administer two types of insulin to a client with diabetes mellitus. What is the correct procedure for preparing this medication?

Obtain a repeat fingerstick glucose level.

A nurse obtains a fingerstick glucose level of 45 mg/dl on a client newly diagnosed with diabetes mellitus. The client is alert and oriented, and the client's skin is warm and dry. How should the nurse intervene?

138 mg/dL, 2 hours postprandial.

A patient who is 6 months' pregnant was evaluated for gestational diabetes mellitus. The doctor considered prescribing insulin based on the serum glucose result of:

Serum glycosylated hemoglobin (Hb A1c)

Laboratory studies indicate a client's blood glucose level is 185 mg/dl. Two hours have passed since the client ate breakfast. Which test would yield the most conclusive diagnostic information about the client's glucose use?

Slows the progression of the disease

The home health nurse is caring for a client with Parkinson's disease. The nurse understands that the purpose of adding selegiline with carbidopa-levodopa to the medication regime should result in which purpose?

it enhances the transport of glucose across the membrane

The nurse is describing the action of insulin in the body to a client newly diagnosed with type 1 diabetes. Which of the following would the nurse explain as being the primary action?

Serum osmolarity

A client with a tentative diagnosis of hyperosmolar hyperglycemic nonketotic syndrome (HHNS) has a history of type 2 diabetes that is being controlled with an oral diabetic agent, tolazamide. Which laboratory test is the most important for confirming this disorder?

"Your child will need less blood work as his glucose levels stabilize."

A physician orders blood glucose levels every 4 hours for a 4-year-old child with brittle type 1 diabetes. The parents are worried that drawing so much blood will traumatize their child. How can the nurse best reassure the parents?

Synthesis of glucose from noncarbohydrate sources.

Insulin is a hormone secreted by the Islets of Langerhans and is essential for the metabolism of carbohydrates, fats, and protein. The nurse understands the physiologic importance of gluconeogenesis, which refers to the:

Kussmaul respirations (fast, labored breathing) and renal shutdown

Ketoacidosis needs to be treated to prevent further complications such as

"For most clients, surgery is an effective treatment for this type of tumor."

The nurse is seeing a client in the oncology outpatient clinic. The client has recently been diagnosed with grade I meningioma. The client asks, "Is there a cure for my condition?" How should the nurse respond?

Carbohydrates 55%, fat 25%, and protein 20%

The nurse practitioner worked with a registered dietitian to customize a 1,800-calorie diabetic diet for a 53-year-old man with special dietary needs. Which of the following percent distributions of calories should be provided?

4-6 hrs

What is the duration of regular insulin?

pioglitazone

Which of the following medications is considered a glitazone?

In hyperglycemia,

urine osmolarity (the measurement of dissolved particles in the urine) increases as glucose particles move into the urine. The client experiences glucosuria and polyuria, losing body fluids and experiencing deficient fluid volume.