Chapter 51-1

A controlled type 2 diabetic client states, "The doctor said if my blood sugars remain stable, I may not need to take any medication." Which response by the nurse is most appropriate?

"Diet, exercise, and weight loss can eliminate the need for medication."

The client asks the nurse if dipstick of urine can be used for monitoring glucose levels. Which is the best response by the nurse?

"The most accurate way to monitor glucose levels is by blood testing."

A recently widowed diabetic comments that her blood sugar levels are running higher than usual. Which is the best response from the nurse?

"This must be a stressful time for you."

A nurse is assigned to care for a patient who is suspected of having type 2 diabetes. Select all the clinical manifestations that the nurse knows could be consistent with this diagnosis.

-Blurred or deteriorating vision -Fatigue and irritability -Polyuria and polydipsia -Wounds that heal slowly or respond poorly to treatment

A client has been diagnosed with prediabetes. How can the client delay or avoid type 2 diabetes?

-weight loss -increased physical activity

The nurse performs a fingerstick blood glucose level of a client with diabetes before lumch. The nurse would notify the physician for which blood glucose level?

145 mg/dL

Carbohydrate counting is a flexible alternative to using the exchange system. Each choice of carbohydrates equals how many grams of carbohydrate?

15g

A client with diabetes comes to the clinic for a follow-up visit. The nurse reviews the client's glycosylated hemoglobin test results. Which result would indicate to the nurse that the client's blood glucose level has been well controlled?

6.5%

A diabetic client is having difficulty with blood glucose control even though the client claims to be following a strict diet, exercise, and medication regime. Which of the following conditions would the nurse suspect to be the most likely cause of poor control?

Emphysema

Which is the primary dietary consideration for a client receiving insulin isophane suspension (NPH) at breakfast?

Encourage midday snack.

A nurse practitioner ordered blood work for a 65-year-old man who is hypertensive and obese. Which of the following results is consistent with a diagnosis of prediabetes?

Fasting plasma glucose of 128 mg/dL

A client with type 1 diabetes mellitus is receiving short-acting insulin to maintain control of blood glucose levels. In providing glucometer instructions, the nurse would instruct the client to use which site for most accurate findings?

Finger

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

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

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

Fruity breath

A diabetic client maintains glucose control with the use of long-acting and short-acting insulin. Which nursing instruction would be considered a priority teaching issue for this client?

If using Lantus or Levemir, give in separate syringe.

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

Which factor presents the most likely cause for weight gain in a diabetic client who is controlled with insulin?

Insulin is an anabolic hormone.

The nurse is preparing a presentation for a group of adults at a local community center about diabetes. Which of the following would the nurse include as associated with type 2 diabetes?

Insulin resistance or insufficient insulin production

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?

It carries glucose into body cells.

The three classic symptoms of both types of diabetes include all of the following EXCEPT:

Polycythemia

Which is the primary reason for encouraging injection site rotation in an insulin dependent diabetic?

Promote absorption.

The nurse is explaining glycosylated hemoglobin testing to a diabetic client. Which of the following provides the best reason for this order?

Reflects the amount of glucose stored in hemoglobin over past several months.

A male client, aged 42 years, is diagnosed with diabetes mellitus. He visits the gym regularly and is a vegetarian. Which of the following factors is important when assessing the client?

The client's consumption of carbohydrates

The nurse understands that a client with diabetes mellitus is at greater risk for developing which of the following complications?

Urinary tract infections

Lipolysis is the process of:

breakdown of fat resulting in fatty acids and ketones