Adaptive Quizzes- Chapter 51 Diabetes

- Do not mix with other insulins. Because glargine is in a suspension with a pH of 4, it cannot be mixed with other insulins because this would cause precipitation. Glargine is a "peakless" basal insulin that is absorbed very slowly over a 24-hour period and can be given once a day.

Which information should be included in the teaching plan for a client receiving glargine, which is "peakless" basal insulin? - Administer the total daily dosage in 2 doses. - Draw up the drug first, then add regular insulin. - Glargine is rapidly absorbed and has a fast onset of action. - Do not mix with other insulins.

- Regular Regular insulin is administered intravenously to treat DKA. It is added to an IV solution and infused continuously. Glargine, NPH, and Lente are only administered subcutaneously.

A client is admitted to the unit with diabetic ketoacidosis (DKA). Which insulin would the nurse expect to administer intravenously? - Glargine - Regular - NPH - Lente

- 1/2 cup fruit juice or regular soft drink In a client with hypoglycemia, the nurse uses the rule of 15: give 15 g of rapidly absorbed carbohydrate, wait 15 minutes, recheck the blood sugar, and administer another 15 g of glucose if the blood sugar is not above 70 mg/dL. One-half cup fruit juice or regular soft drink is equivalent to the recommended 15 g of rapidly absorbed carbohydrate.

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

- Administering 1 ampule of 50% dextrose solution, per physician's order The nurse should administer 50% dextrose solution to restore the client's physiological integrity. Dextrose will increase the glucose levels, since the patient is suffering from hypoglycemia

A client with type 1 diabetes presents with a decreased level of consciousness and a fingerstick glucose level of 39 mg/dl. His family reports that he has been skipping meals in an effort to lose weight. Which nursing intervention is most appropriate? - Inserting a feeding tube and providing tube feedings - Administering a 500-ml bolus of normal saline solution - Administering 1 ampule of 50% dextrose solution, per physician's order - Observing the client for 1 hour, then rechecking the fingerstick glucose level

- The client's consumption of carbohydrates While assessing a client, it is important to note the client's consumption of carbohydrates because he has high blood sugar.

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 - History of radiographic contrast studies that used iodine - The client's mental and emotional status - The client's exercise routine

- Control blood glucose levels. Controlling blood glucose levels and any hypertension can prevent or delay the development of diabetic nephropathy.

A nurse educates a group of clients with diabetes mellitus on the prevention of diabetic nephropathy. Which of the following suggestions would be most important? - Control blood glucose levels. - Drink plenty of fluids. - Take the antidiabetic drugs regularly. - Eat a high-fiber diet.

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 Glucose supplies most of the calories in TPN; if the glucose infusion rate exceeds the client's rate of glucose metabolism, hyperglycemia arises. When the renal threshold for glucose reabsorption is exceeded, osmotic diuresis occurs, causing an 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." Attending to the mother's needs is a critical part of caring for a sick child. In this case however, administering insulin in a prompt manner supersedes the mother's needs. By informing the mother that she's going to administer the insulin and will then make time to talk with her, the nurse recognizes the mother's needs as legitimate.

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."

- 180 mg/dL Glycosuria occurs when the renal threshold for sugar exceeds 180 mg/dL. Glycosuria leads to an excessive loss of water and electrolytes (osmotic diuresis).

A nurse knows to assess a patient with type 1 diabetes for postprandial hyperglycemia. The nurse knows that glycosuria is present when the serum glucose level exceeds: - 120 mg/dL - 140 mg/dL - 160 mg/dL - 180 mg/dL

- Regular Short-acting insulins are called regular insulin (marked R on the bottle). Regular insulin is a clear solution and is usually administered 20 to 30 minutes before a meal, either alone or in combination with a longer-acting insulin. Regular insulin is the only insulin approved for IV use.

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? - NPH - Regular - Lispro - Lantus

- "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."