BAH Ch. 51

50% to 60%

The nurse expects that a patient with type 1 diabetes may receive what percentage of the usual morning dose of insulin?

Regular

The nurse is administering an insulin drip to a patient in ketoacidosis. What insulin does the nurse know is the only one that can be used intravenously?

1. Leakage of fluid or serum (exudate) 2. Microaneurysms 3. Focal capillary single closure

The nurse is assessing a patient with nonproliferative (background) retinopathy. When examining the retina, what would the nurse expect to assess? (Select all that apply)

Lower than 50 to 60 mg/dL

The nurse is caring for a patient with an abnormally low blood glucose concentration. What glucose level will the nurse observe when assessing laboratory results?

1. May improve blood glucose levels 2. Decrease the need for exogenous insulin 3. Help reduce cholesterol levels

The nurse is educating the patient with diabetes about the importance of increasing dietary fiber. What should the nurse explain is the rationale for the increase? (Select all that apply)

0.45% normal saline

The nurse is preparing to administer IV fluids for a patient with ketoacidosis who has a history of hypertension and congestive heart failure. What order for fluids would the nurse anticipate infusing for this patient?

"Eating the fruit instead of drinking juice decreases the glycemic index by slowing absorption"

The nurse is educating a patient about the benefits of fruit versus fruit juice in the diabetic diet. The patient states, "What difference does it make if you drink the juice or eat the fruit? It is all the same." What is the best response by the nurse?

Review 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?

1000 calories

A female patient with diabetes who weighs 130 pounds has an ideal body weight of 116 lb. For weight reduction of 2 lb/week, approximately what should her daily caloric intake be?

Elevated blood glucose levels

A finding of ___ is the basic criterion for the diagnosis of diabetes

1. Glucogenolysis 2. Gluconeogenesis

Because insulin normally inhibits ___ and ___ these processes occur in an unrestrained fashion in people with insulin deficiency and contribute further to hyperglycemia

1. Nontraumatic amputation 2. Blindness 3. End-stage kidney stages

In the United states, diabetes is the leading cause of ___, ___, and ___

Gluconeogenesis

New glucose is produced from amino acids

Nephropathy

Small vessel disease affects the kidneys

1. Ketosis prone 2. Little endogenous insulin 3. Older than 65 years of age

A patient is diagnosed with type 1 diabetes, What clinical characteristics does the nurse expect to see in this patient? (Select all that apply)

Hypokalemia

A patient with diabetes, ketoacidosis has had a large volume of fluid infused for rehydration should the nurse monitor for?

Hyperglycemic hyperosmolar syndrome

An older adult patient is in the hospital being treated for sepsis related to a urinary tract infection. The patient has started to have an altered sense of awareness, profound dehydration, and hypotension. What condition does the nurse suspect the patient is experiencing?

Peripheral neuropathy

An older adult patient that has diabetes type 2 comes to the emergency department with second degree burns to the bottom of both feet and states, "I didn't feel too hot but my feet must have been too close to the heater." What does the nurse understand is most likely the reason for the decrease in temperature sensation?

Glycosuria

Filtered glucose that the kidney cannot absorb spills over into urine

25.8

It is estimated that more than ___ million people in the United States have diabetes, although almost one third of these cases are undiagnosed

Retinopathy

Microvascular changes develop in the eyes

Seventh, 20%

Type 2 diabetes is the ___ leading cause of death and affects approximately ___ of older adults

ketoacidosis

___ is the most common risk of insulin pump therapy

Albumin

A nurse is caring for a patient with diabetes that has a diagnosis of nephropathy. What would the nurse expect the urinalysis report to indicate?

18%

Gestational diabetes occurs in as many as ___ of pregnant women and increases their risk for hypertensive disorders during pregnancy

1. Insulin resistance 2. Impaired insulin secretion

What are two main problems related to insulin in type 2 diabetes?

105mg/dL; 130mg/dL

Goals for blood glucose levels during pregnancy are ___ or less before meals and ___ or less 2 hours after meals

Directly stimulates the beta cells of the pancreas to secrete insulin

How do sulfonylureas act for patients with type 2 diabetes (Can not be used in patients with type 1 DM)

decreased

Insulin resistance refers to a ___ tissue sensitivity to insulin

1. Type 1 2. Type 2 3. Gestational

The major classifications of diabetes are: ___, ___, and ___

NPH

The nurse is preparing to administer intermediate-acting insulin to a patient with diabetes. Which insulin will the nurse administer?

24-28

A woman at average risk for the development of hyperglycemia during pregnancy should be tested at ___ weeks of gestation

1. Polyuria, 2. Polydipsia 3. Polyphagia

Classic clinical manifestations of diabetes include the "three P's"

Glycogenolysis

Glycogen breaks down in the liver through the action of glucagon

Hyperglycemic hyperosmolar syndrome

Uncontrolled type 2 diabetes may lead to an acute problem

Osmotic diuresis

When excess glucose is excreted in the urine, it is accompanied by excessive loss of fluids and electrolytes, which is called

Hypoglycemia

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

Because of the secretion of placental hormones which causes insulin resistance

Why does hyperglycemia develop during pregnancy?

Because of increasing health care costs and older adults

Why does the economic cost of diabetes continue to increase?

1. Hyperglycemia 2. Ketosis 3. Metabolic Acidosis

___, ___, and ___ are the three metabolic derangements that occur in diabetic ketoacidosis