Adult health prep u chapter 46

Serum potassium level

After being sick for 3 days, a client with a history of diabetes mellitus is admitted to the hospital with diabetic ketoacidosis (DKA). The nurse should evaluate which diagnostic test results to prevent dysrhythmias? Serum potassium level Serum calcium level Serum sodium level Serum chloride level

at least three times per week.

During a class on exercise for clients with diabetes mellitus, a client asks the nurse educator how often to exercise. To meet the goals of planned exercise, the nurse educator should advise the client to exercise: at least once per week. at least three times per week. at least five times per week. every day.

Intermediate-acting

NPH is an example of which type of insulin? Rapid-acting Short-acting Intermediate-acting Long-acting

Lispro

Which type of insulin acts most quickly? Regular NPH Lispro Glargine

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? Fasting blood glucose level Glucose via a urine dipstick test Glycosylated hemoglobin level Glucose via an oral glucose tolerance test

Do not mix with other insulins.

Which information should be included in the teaching plan for a client receiving glargine, a "peakless" basal insulin? Administer the total daily dosage in two doses. Draw up the drug first, then add regular insulin. It is rapidly absorbed and has a fast onset of action. Do not mix with other insulins.

"Always follow the same order when drawing the different insulins into the syringe."

Which instruction about insulin administration should a nurse give to a client? "Always follow the same order when drawing the different insulins into the syringe." "Shake the vials before withdrawing the insulin." "Store unopened vials of insulin in the freezer at temperatures well below freezing." "Discard the intermediate-acting insulin if it appears cloudy."

Albumin

A nurse is caring for a diabetic patient with a diagnosis of nephropathy. What would the nurse expect the urinalysis report to indicate? Albumin Bacteria Red blood cells White blood cells

When mixing insulin, the regular insulin is drawn up into the syringe first.

The nurse is teaching a client about self-administration of insulin and about mixing regular and neutral protamine Hagedorn (NPH) insulin. Which information is important to include in the teaching plan? If two different types of insulin are ordered, they need to be given in separate injections. When mixing insulin, the NPH insulin is drawn up into the syringe first. When mixing insulin, the regular insulin is drawn up into the syringe first. There is no need to inject air into the bottle of insulin before withdrawing the insulin.

nsulin is an anabolic hormone.

A diabetic client using insulin reports weight gain. Which response from the nurse explains the most likely cause of the weight increase? Insulin is an anabolic hormone. Insulin provides more efficient use of glucose. Faulty fat metabolism is shut off. Weight gain is attributed to fluid retention.

Dietitian

A nurse is preparing a client with type 1 diabetes for discharge. The client can care for himself; however, he's had a problem with unstable blood glucose levels in the past. Based on the client's history, he should be referred to which health care worker? Home health nurse Dietitian Psychiatrist Social worker

"I might need insulin later on but probably not as much or as often."

After teaching a client with type 1 diabetes who is scheduled to undergo an islet cell transplant, which client statement indicates successful teaching? "This transplant will provide me with a cure for my diabetes." "I will receive a whole organ with extra cells to produce insulin." "They'll need to create a connection from the pancreas to allow enzymes to drain." "I might need insulin later on but probably not as much or as often."

ncreased thirst, hunger, and urination

A nurse is providing education to a client who is newly diagnosed with diabetes mellitus. What are classic symptoms associated with diabetes? Increased thirst, hunger, and urination Increased weight loss, dehydration, and fatigue Loss of appetite, increased urination, and dehydration Increased weight gain, appetite, and thirst

Blood glucose level 1,100 mg/dl

A client is admitted with hyperosmolar hyperglycemic nonketotic syndrome (HHNS). Which laboratory finding should the nurse expect in this client? Arterial pH 7.25 Plasma bicarbonate 12 mEq/L Blood glucose level 1,100 mg/dl Blood urea nitrogen (BUN) 15 mg/dl

Increases ability for glucose to get into the cell and lowers blood sugar

The client who is managing diabetes through diet and insulin control asks the nurse why exercise is important. Which is the best response by the nurse to support adding exercise to the daily routine? Increases ability for glucose to get into the cell and lowers blood sugar Creates an overall feeling of well-being and lowers risk of depression Decreases need for pancreas to produce more cells Decreases risk of developing insulin resistance and hyperglycemia

Stabilize the skin by pinching an area. Hold the syringe as if holding a pencil. Insert the needle straight into the skin. Push the plunger of the syringe. Pull the needle straight out of the skin. Press a cotton ball over the injection site. Discard the syringe into a hard container.

The nurse is instructing a client on the self-administration of insulin. Place in order the steps that the nurse will instruct the client to take.

It cannot be mixed with any other type of insulin.

Which statement is correct regarding glargine insulin? Its peak action occurs in 2 to 3 hours. It cannot be mixed with any other type of insulin. It is absorbed rapidly. It is given twice daily.

Rapid, thready pulse

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? Cool, moist skin Rapid, thready pulse Arm and leg trembling Slow, shallow respirations

Rotate injection sites within the same anatomic region, not among different regions."

A client with diabetes mellitus must learn how to self-administer insulin. The physician has ordered 10 units of U-100 regular insulin and 35 units of U-100 isophane insulin suspension (NPH) to be taken before breakfast. When teaching the client how to select and rotate insulin injection sites, the nurse should provide which instruction? "Inject insulin into healthy tissue with large blood vessels and nerves." "Rotate injection sites within the same anatomic region, not among different regions." "Administer insulin into areas of scar tissue or hypertrophy whenever possible." "Administer insulin into sites above muscles that you plan to exercise heavily later that day."

rapid-acting insulin only.

A client with type 1 diabetes has been on a regimen of multiple daily injection therapy. He's being converted to continuous subcutaneous insulin therapy via an insulin pump. While teaching the client about continuous subcutaneous insulin therapy, the nurse should tell him that the regimen includes the use of: intermediate- and long-acting insulins. short- and long-acting insulins. rapid-acting insulin only. short- and intermediate-acting insulins.

Insulin is absorbed more rapidly at abdominal injection sites than at other sites.

A nurse explains to a client that she will administer his first insulin dose in his abdomen. How does absorption at the abdominal site compare with absorption at other sites? Insulin is absorbed more slowly at abdominal injection sites than at other sites. Insulin is absorbed rapidly regardless of the injection site. Insulin is absorbed more rapidly at abdominal injection sites than at other sites. Insulin is absorbed unpredictably at all injection sites.

15 to 20 g of a fast-acting carbohydrate such as orange juice.

A nurse is caring for a client with type 1 diabetes who exhibits confusion, light-headedness, and aberrant behavior. The client is conscious. The nurse should first administer: I.M. or subcutaneous glucagon. I.V. bolus of dextrose 50%. 15 to 20 g of a fast-acting carbohydrate such as orange juice. 10 units of fast-acting insulin.

100 units of regular insulin in normal saline solution

A nurse is preparing a continuous insulin infusion for a child with diabetic ketoacidosis and a blood glucose level of 800 mg/dl. Which solution is the most appropriate at the beginning of therapy? 100 units of regular insulin in normal saline solution 100 units of neutral protamine Hagedorn (NPH) insulin in normal saline solution 100 units of regular insulin in dextrose 5% in water 100 units of NPH insulin in dextrose 5% in water

Reviewing the patient's diet history to identify eating habits and lifestyle and cultural eating patterns

A patient has been newly diagnosed with type 2 diabetes, and the nurse is assisting with the development of a meal plan. What step should be taken into consideration prior to making the meal plan? Making sure that the patient is aware that quantity of foods will be limited Ensuring that the patient understands that some favorite foods may not be allowed on the meal plan and substitutes will need to be found Determining whether the patient is on insulin or taking oral antidiabetic medication Reviewing the patient's diet history to identify eating habits and lifestyle and cultural eating patterns

10 to 15 g of a simple carbohydrate.

An agitated, confused client arrives in the emergency department. The client's history includes type 1 diabetes, hypertension, and angina pectoris. Assessment reveals pallor, diaphoresis, headache, and intense hunger. A stat blood glucose sample measures 42 mg/dl, and the client is treated for an acute hypoglycemic reaction. After recovery, the nurse teaches the client to treat hypoglycemia by ingesting: 2 to 5 g of a simple carbohydrate. 10 to 15 g of a simple carbohydrate. 18 to 20 g of a simple carbohydrate. 25 to 30 g of a simple carbohydrate.

insulin resistance

Which is a characteristic of type 2 diabetes? insulin resistance presence of islet antibodies little or no insulin ketosis-prone when insulin absent

10 to 15 minutes

The nurse is administering lispro insulin. Based on the onset of action, how long before breakfast should the nurse administer the injection? 10 to 15 minutes 30 to 40 minutes 1 to 2 hours 3 hours

weight loss

Which factor is the focus of nutrition intervention for clients with type 2 diabetes? weight loss carbohydrate intake protein metabolism blood glucose level

1/2 cup fruit juice or regular soft drink

A client with diabetes mellitus has a blood glucose level of 40 mg/dL. Which rapidly absorbed carbohydrate would be mosteffective? 1/2 cup fruit juice or regular soft drink 4 oz of skim milk 1/2 tbsp honey or syrup three to five LifeSavers candies

Serum glucose level of 52 mg/dl

A client with diabetes mellitus has a prescription for 5 units of U-100 regular insulin and 25 units of U-100 isophane insulin suspension (NPH) to be taken before breakfast. At about 4:30 p.m., the client experiences headache, sweating, tremor, pallor, and nervousness. What is the most probable cause of these signs and symptoms? Serum glucose level of 450 mg/dl Serum glucose level of 52 mg/dl Serum calcium level of 8.9 mg/dl Serum calcium level of 10.2 mg/dl

Sweating, tremors, and tachycardia

A client with status asthmaticus requires endotracheal intubation and mechanical ventilation. Twenty-four hours after intubation, the client is started on the insulin infusion protocol. The nurse must monitor the client's blood glucose levels hourly and watch for which early signs and symptoms associated with hypoglycemia? Sweating, tremors, and tachycardia Dry skin, bradycardia, and somnolence Bradycardia, thirst, and anxiety Polyuria, polydipsia, and polyphagia

Blood pH of 6.9

The nurse is reviewing the initial laboratory test results of a client diagnosed with DKA. Which of the following would the nurse expect to find? Blood glucose level of 250 mg/dL Blood pH of 6.9 Serum bicarbonate of 19 mEq/L PaCO2 of 40 mm Hg

Coma, anxiety, confusion, headache, and cool, moist skin

A client's blood glucose level is 45 mg/dl. The nurse should be alert for which signs and symptoms? Coma, anxiety, confusion, headache, and cool, moist skin Kussmaul respirations, dry skin, hypotension, and bradycardia Polyuria, polydipsia, hypotension, and hypernatremia Polyuria, polydipsia, polyphagia, and weight loss

A glucose challenge test should be performed between 24 and 28 weeks.

Which statement is true regarding gestational diabetes? It occurs in most pregnancies. Onset usually occurs in the first trimester. A glucose challenge test should be performed between 24 and 28 weeks. There is a low risk for perinatal complications.

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? Increased risk for urologic complications Need for exocrine enzymatic drainage Underlying problem of insulin resistance Need for lifelong immunosuppressive therapy

Nervousness, diaphoresis, and confusion

A nurse expects to find which signs and symptoms in a client experiencing hypoglycemia? Polyuria, headache, and fatigue Polyphagia and flushed, dry skin Polydipsia, pallor, and irritability Nervousness, diaphoresis, and confusion

increased urine output

A nurse is assessing a client who is receiving total parenteral nutrition (TPN). Which finding suggests that the client has developed hyperglycemia? Cheyne-Stokes respirations Increased urine output Decreased appetite Diaphoresis

I'm going to give your son some insulin. Then I'll be happy to talk with you."

A nurse is preparing to administer insulin to a child who's just been diagnosed with type 1 diabetes. When the child's mother stops the nurse in the hall, she's crying and anxious to talk about her son's condition. The nurse's best response is: "I can't talk now. I have to give your son his insulin as soon as possible." "If you'll wait in your son's room, the physician will talk with you as soon as he's free." "Everything will be just fine. I'll be back in a minute and then we can talk." "I'm going to give your son some insulin. Then I'll be happy to talk with you."

Blood glucose can be controlled through diet and exercise

Which clinical characteristic is associated with type 2 diabetes (previously referred to as non-insulin-dependent diabetes mellitus)? Blood glucose can be controlled through diet and exercise Client is usually thin at diagnosis Client is prone to ketosis Clients demonstrate islet cell antibodies

The client has eaten and has not taken or received insulin.

Which of the following factors would a nurse identify as a most likely cause of diabetic ketoacidosis (DKA) in a client with diabetes? The client continues medication therapy despite adequate food intake. The client has not consumed sufficient calories. The client has been exercising more than usual. The client has eaten and has not taken or received insulin.

polyphagia.

A client has been recently diagnosed with type 2 diabetes, and reports continued weight loss despite increased hunger and food consumption. This condition is called: polyphagia. polydipsia. polyuria. anorexia.

"You should take your insulin after breakfast and after dinner."

Health teaching for a patient with diabetes who is prescribed Humulin N, an intermediate NPH insulin, would include which of the following advice? "Your insulin will begin to act in 15 minutes." "You should expect your insulin to reach its peak effectiveness by 9:00 AM if you take it at 8:00 AM." "You should take your insulin after breakfast and after dinner." "Your insulin will last 8 hours, and you will need to take it three times a day."

Increase frequency of glucose self-monitoring.

The nurse is educating the client with diabetes on setting up a sick plan to manage blood glucose control during times of minor illness such as influenza. Which is the most important teaching item to include? Increase frequency of glucose self-monitoring. Decrease food intake until nausea passes. Do not take insulin if not eating. Take half the usual dose of insulin until symptoms resolve.