Ch 46 Diabetes PrepU

Need exogenous insulin

A patient who is diagnosed with type 1 diabetes would be expected to: 1499

10-15 g simple carbs

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:

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: 1490

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? 1509

Cannot be mixed with other insulin

Which statement is correct regarding glargine insulin? 1500

Begin fluid replacements.

A child is brought into the emergency department with vomiting, drowsiness, and blowing respirations. The child's parent 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? 1515

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? 1515

180 mg/dL

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: 1490

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: 1491

Hypokalemia

A patient with diabetic ketoacidosis (DKA) has had a large volume of fluid infused for rehydration. What potential complication from rehydration should the nurse monitor for? 1517

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? 1516-1517

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? 1512

Glucagon

A nurse is teaching a client with type 1 diabetes how to treat adverse reactions to insulin. To reverse hypoglycemia, the client ideally should ingest an oral carbohydrate. However, this treatment isn't always possible or safe. Therefore, the nurse should advise the client to keep which alternate treatment on hand? 1513

"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? 1509

6.5%

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? 1492

Metmorfin

A client with diabetes is receiving an oral anti diabetic agent that acts to help the tissues use available insulin more efficiently. Which of the following agents would the nurse expect to administer? 1491

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? 1512

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? 1490

Nervousness, diaphoresis, and confusion

A nurse expects to find which signs and symptoms in a client experiencing hypoglycemia? 1512

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? 1509

Less than 70 mg/dL (3.7 mmol/L)

A nurse is caring for a client with an abnormally low blood glucose concentration. What glucose level should the nurse observe when assessing laboratory results? 1512

Albumin

A nurse is caring for a diabetic patient with a diagnosis of nephropathy. What would the nurse expect the urinalysis report to indicate? 1520

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? 1516

15 g carbs

A nurse is teaching a client with diabetes mellitus about self-management of his condition. The nurse should instruct the client to administer 1 unit of insulin for every: 1495

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

Which statement is true regarding gestational diabetes? 1491

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? 1496

Regular

What is the only insulin that can be given intravenously? A client is admitted to the unit with diabetic ketoacidosis (DKA). Which insulin would the nurse expect to administer intravenously? 1500

Sulfonylureas

Which category of oral antidiabetic agents exerts the primary action by directly stimulating the pancreas to secrete insulin? 1504-1505

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? 1514