Chapter 38

It is possible with weight loss and exercise to discontinue the use of antidiabetic medication.

Which would be appropriate to include in teaching a client with type 2 diabetes?

insulin glargine

After reviewing information about different insulin preparations, a nursing student demonstrates understanding of the information when the student identifies which medication as an example of a long-acting insulin?

liver enzymes

Rosiglitazone is being considered for the treatment of diabetes in an adult client. Before the initiation of rosiglitazone therapy, the nurse should review what laboratory work recently drawn?

Massaging the site after removing the needle

Which would be least appropriate when administering insulin by subcutaneous injection?

06:45

The client is scheduled to get a breakfast tray at 07:00. At what time should the client receive a prescribed dose of insulin lispro?

Amylin

What hormone, secreted with insulin, increases satiety and suppresses glucagon secretion?

weakness, sweating, and decreased mentation.

The nurse is caring for a client who is taking insulin. The nurse suspects the client is experiencing hypoglycemia when the client displays what signs?

Lifelong exogenous insulin is required.

The two major classifications of diabetes are type 1 and type 2. What is a distinguishing characteristic of type 1 diabetes?

Fruity breath odor

What would alert the nurse to suspect that a client is developing ketoacidosis?

Insulin is needed because the beta cells of the pancreas are no longer functioning.

A client newly diagnosed with type 1 diabetes asks the nurse why the client cannot just take a pill. The nurse would incorporate what knowledge when responding to this client?

"I'm disappointed, but I take some solace in the fact that I won't ever have to have insulin injections."

A client newly diagnosed with type 2 diabetes has attended educational sessions to provide insight into the diagnosis. Which of the client's statements should prompt the nurse to provide further teaching?

Hypoglycemia

The health care provider has ordered a change of prescription from rapid-acting insulin to an intermediate-acting type. Which adverse effect must the nurse closely monitor for in the client?

Allergy to sulfonamides

The nurse is caring for a client who has been prescribed glyburide. Which factor, if identified in the client history, would cause the nurse to inform the health care provider of a contraindication to use?

hyperglycemia

The nurse is caring for a client who is taking glyburide as treatment for type 2 diabetes mellitus. The health care provider has added a corticosteroid to this client's medication regimen for treatment of a severe allergic reaction. The nurse knows that this drug combination may cause what adverse effect on this client?

"Insulin assists glucose molecules to enter the cells of muscle and fat tissues."

The nurse is discussing diabetes with a group of individuals who are at risk for the disease. Which statement by a participant indicates an understanding of the role of insulin in the disease?

Do not give pramlintide in the same site where insulin is administered.

The nurse is educating a client who will be adding an injection of pramlintide to his insulin regimen. What information is most important for the nurse to share with this client to ensure safe medication administration?

HbA1c

The nurse is interviewing a client who was diagnosed with type 2 diabetes four months ago. The client does not record glucometer readings. What laboratory test does the nurse anticipate the health care provider will order for this client?

Have a colleague confirm the dosage.

The nurse is preparing to administer 20 units of NPH insulin to a client. Before administering the medication, the nurse should implement which intervention?

Regular insulin

The nurse is preparing to administer insulin intravenously to a client with a blood glucose level over 600 mg/dL (33.33 mmol/L). What type of insulin will the nurse most likely give?

Garlic

The nurse is providing education to a client who has been prescribed therapy with an antidiabetic medication. During teaching, the nurse will caution the client against heavy intake of which herb?

Orange or other fruit juice Glucose tablets Hard candy

The nurse monitoring a client receiving insulin glulisine notices the client has become confused, diaphoretic, and nauseated. The nurse checks the client's blood glucose and it is 60 mg/dL (3.33 mmol/L). Which can a nurse give to treat a client with a hypoglycemic episode? (Select all that apply.)

Ketones in the urine Flushed, dry skin

The nurse who has admitted a client with diabetic ketoacidosis should look for what assessment findings that are consistent with this diagnosis? (Select all that apply.)

Insert the needle at a 45-degree angle for injection.

When administering insulin, what would be most appropriate?

regular

When considering the management of diabetic ketoacidosis (DKA), what type of insulin can be administered intravenously?

Increases insulin release

When describing the effects of incretins on blood glucose control to a group of students, which would an instructor include?

The client must have functioning pancreatic beta cells.

Which condition must be met in order for glyburide treatment to be effective?

Glycosylated hemoglobin levels

Which is the best indicator of overall diabetic control?

Glyburide

Which would a nurse identify as an example of a sulfonylurea?

Additive effects

Oral anti-diabetic agents can be used in various combinations for what purpose?

"Regular exercise makes your body better able to use the insulin it produces."

A client has been newly diagnosed with type 2 diabetes. What statement would be appropriate for the nurse to include in the teaching?

insulin lispro

A client's current condition requires rapid reduction of blood sugar levels. Which type of insulin will have the most rapid onset of action?

Assist the client in making menus that will meet the needs of both the client and the family. Watch the client draw up and administer her insulin. Reinforce instructions on dealing with hypoglycemia.

A female client is a newly diagnosed diabetic. She is a stay-at-home mother and responsible for meal planning and management of the home. What will the home care nurse teach this client? (Select all that apply.)

Client's average blood glucose is above normal.

A female client visits the health care provider's office after routine labs are drawn. The nurse notes that her A1C is 9. How does the nurse interpret this finding?

Glucagon

A man is brought to the emergency department. He is nonresponsive, and his blood glucose level is 32 mg/dL. Which would the nurse expect to be ordered?

Inspect the previous injection site for inflammation.

A nurse at a health care facility is assigned to administer insulin to the patient. Which intervention should the nurse perform before administering each insulin dose?

All the above

A nurse diabetes educator is planning an initial visit to a home care client who was recently diagnosed with diabetes mellitus. Which skills would the nurse help the client learn?

Give oral fluids or candy.

A nurse is caring for a patient who has developed a hypoglycemic reaction. Which intervention should the nurse perform if swallowing and gag reflexes are present in the patient?

Observe the patient for hypoglycemic episodes.

A nurse is caring for a patient with diabetes mellitus who is receiving an oral antidiabetic drug. Which of following ongoing assessments should the nurse perform when caring for this patient?

It slows the rate of inactivation of the incretin hormones.

What is the expected action of sitagliptin on type 2 diabetes?

Maintaining adequate intravenous fluid delivery

A client diagnosed with diabetes is demonstrating slow, deep respirations and is difficult to arouse. Which nursing intervention is directed specifically at treating this serious complication of diabetes?

Assess the most recent hemoglobin A1C levels.

A client who began treatment for type 2 diabetes 8 months ago is now meeting with a diabetic nurse for a scheduled follow-up. How can the nurse best assess the client's glycemic control since beginning treatment?

It slows gastric emptying.

A client with a diagnosis of diabetes is prescribed pramlintide. How will this drug assist in controlling the client's blood sugar?

the past 3 or 4 months

A client with diabetes is undergoing testing for glycosylated hemoglobin. The nurse instructs the client that this test measures average blood glucose over what time period?

insulin lispro

A nurse is preparing to administer a rapid-acting insulin. Which medication would the nurse most likely administer?

It is a complicated disorder that alters the metabolism of glucose.

A nurse is presenting an educational event at a local senior citizens' club about diabetes. What would the nurse tell the attendees at the event about diabetes?

"I am on the middle school track team."

A nurse is providing client education to a 13-year-old girl who was just diagnosed with type 1 diabetes mellitus. Which statement by the client will alert the nurse that special instructions regarding insulin are necessary?

Tachycardia

A patient at a health care facility has been prescribed diazoxide for hypoglycemia due to hyperinsulinism. What adverse reactions to the drug should the nurse monitor for in the patient?