Chapter 51: Assessment and Management of Patients with Diabetes (2)

A client with type 1 diabetes has a highly elevated glycosylated hemoglobin (Hb) test result. In discussing the result with the client, the nurse is most accurate in stating: pg. 1467

"It tells us about your sugar control for the last 3 months."

A nurse is teaching a client recovering from diabetic ketoacidosis (DKA) about management of "sick days." The client asks the nurse why it is important to monitor the urine for ketones. Which statement is the nurse's best response? pg. 1467

"Ketones accumulate in the blood and urine when fat breaks down in the absence of insulin. Ketones signal an insulin deficiency that will cause the body to start breaking down stored fat for energy."

Which instruction should a nurse give to a client with diabetes mellitus when teaching about "sick day rules"? pg. 1484

"Test your blood glucose every 4 hours."

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: pg. 1482

10 to 15 g of a simple carbohydrate.

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: pg. 1481

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

What is the duration of regular insulin? pg. 1468

4 to 6 hours

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? pg. 1461

6.5%

When administering insulin to a client with type 1 diabetes, which of the following would be most important for the nurse to keep in mind? pg. 1468

Accuracy of the dosage

A client is admitted with hyperosmolar hyperglycemic nonketotic syndrome (HHNS). Which laboratory finding should the nurse expect in this client? pg. 1486

Blood glucose level 1,100 mg/dl

A client's blood glucose level is 45 mg/dl. The nurse should be alert for which signs and symptoms? pg. 1482

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

Which information should be included in the teaching plan for a client receiving glargine, which is "peakless" basal insulin? pg. 1468

Do not mix with other insulins.

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? pg. 1465

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

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? pg. 1459

Insulin resistance or insufficient insulin production

Which type of insulin acts most quickly? pg. 1468

Lispro

A client with diabetes is receiving an oral antidiabetic agent that acts to help the tissues use available insulin more efficiently. Which of the following agents would the nurse expect to administer? pg. 1460

Metformin

The nurse is preparing to administer intermediate-acting insulin to a patient with diabetes. Which insulin will the nurse administer? pg. 1468

NPH

A nurse expects to find which signs and symptoms in a client experiencing hypoglycemia? pg. 1482

Nervousness, diaphoresis, and confusion

A nurse is teaching a diabetic support group about the causes of type 1 diabetes. The teaching is determined to be effective when the group is able to attribute which factor as a cause of type 1 diabetes? pg. 1458

Presence of autoantibodies against islet cells

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? pg. 1468

Regular

What is the only insulin that can be given intravenously? pg. 1471-1472

Regular