chapter 51 BAH

when educating a patient with diabetes about increasing fiber intake, what risk should be discussed?

- it may require adjusting the dosage of insulin or oral agents to prevent hypoglycemia - abdominal fullness, nausea, diarrhea, increased flatulence, and constipation if fluid intake is inadequate

the nurse is preparing to administer IV fluids for a patient with ketoacidosis who has a history of hypertension and congestive heat failure. what order for fluids would the nurse anticipate infusing for this patient?

0.45 normal saline

A female diabetic patient who weight 130 lb has an ideal body weight of 116 lb. for weight reduction of 2 lb/week, approximately what should her daily caloric intake be?

1000 calories

goals for blood glucose levels during pregnancy are

105 mg/dL or less before meals and 130 mg/dL or less 2 hours after meals.

intermediate acting insulin is effective for what duration of time?

16-24 hrs

a woman at average risk for development of hyperglycemia during pregnancy should be tested at

24-28 weeks of gestation

the nurse expects that type 1 diabetic patient may receive what percentage of his or her usual morning dose of insulin preoperative?

50 %-60 %

Because insulin normally inhibits

Glycogenolysis and gluconeogenesis these processes occur in a unrestrained fashion in people with insulin deficiency and contribute further to hyperglycemia

What are the 2 main problems relates to insulin type 2 diabetes?

Insulin resistance impaired insulin secretions

the Nurse is preparing to administer intermediate-acting insulin to a patient with diabetes. which insulin will the nurse administer?

NPH

when excess glucose is excreted in the urine, it is accompanied by excessive loss of fluid and electrolytes, which is called:

Osmotic Diuresis

an older adult patient that has diabetes type 2 comes to the emergency department with second-degree burns to the bottom of both feet ans states," I didn't feel too hot but my feet must have been to close to the heater" What does the nurse understand is most likely the reason for the decrease in temperature sensation?

Peripheral neuropathy

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 IV?

Regular

The major classification of Diabetes are:

Type 1 type 2 Gestattional

why does the cost of diabetes continue to increase?

because of increase of health care cost and aging population

why does hyperglycemia develops during pregnancy?

because of the secretion of placental hormones, which causes insulin resistance

insulin resistance refers to a:

decreased tissue sensitivity to insulin

the nurse is educating the patient with diabetes about the importance of increasing dietary fiber. what should the nurse explain is the rationale for the increase?

eating the fruit instead of drinking juice decreases the glycemic index by slowing absorption.

glucosuria:

filtered glucose that the kidneys cannot absorb spill into urine

glycogenolysis:

glycogen breaks down in the liver through the action of glucagon.

25.8 million of people in the US

have diabetes, although almost one third of these cases are undiagnosed.

what are the 3 metabolic derangement that occur in diabetic ketoacidosis

hyperglycemia ketosis metabolic acidosis

An older adult patient is in the hospital being treated for sepsis related to urinary tract infection. the patient has started to have an altered sense of awareness, profound dehydration, and hypotension. what does the nurse suspect the patient is experiencing?

hyperglycemic hyperosmolar syndrome

uncontrolled type 2 diabetes lead to an acute problem:

hyperglycemic hyperosmolar syndrome

when the nurse is caring for a patient with type 1 diabetes, what clinical manifestation would be a priority to closely monitor?

hypoglycemia

A patient with diabetic ketoacidosis has had a large volume of fluid infused for rehydration. what potential complications the nurse monitor for?

hypokalemia

list the clinical manifestations characteristic of hyperglycemic hyperosmolar sydnrome

hypotension profound dehydration tachycardia variable neurologic sings (seizures,, hemiparesis, (weakness on half of body) alteration of sensorium.

Describe how insulin regulation is altered in the diabetic state?

insulin regulates the production and storage of glucose. in diabetes, either the pancreas stop producing insulin or the cells stop responding to insulin. hyperglycemia results can lead to acute metabolic complications such as diabetic keotacidosis and hyperglycemic hyperosmolar non ketotic syndrome. Long term complications can contribute to macrovascular or microvascular complications

ketoacidosis

is the most common risk of insulin pump therapy

A patient is diagnosed with type 1 diabetes. what clinical characteristics does the nurse expect to see in this patient?

ketosis-prone little endogenous insulin younger than 30 years of age

the nurse is assessing a patient with non-proliferative (background) retinopahty. when examining the retina, what would the nurse expect to assess? select all that apply

leakage of fluid or serum (exudates) microaneurysm focal capillary single closure

retinophaty

microvascular changes develops in the eyes

gluconeogenesis:

new glucose is produce from aminoacids

In the US, diabetes is the leading cause of :

non-traumatic amputations blindness End stage Renal Disease

classic clinical manifestations of diabetes include the 3 P's

polyuria: excessive urination polydipsia: excessive thirst polyphasia: excessive hunger

A patient has been newly diagnosed with type 2 diabetes, and the nurse is assisting with the development of a meal plan. what step should be taken into consideration prior to making the meal plan?

reviewing the patient's diet history to identify habits and lifestyle and cultural eating patterns

Patient with diabetes refuses his bedtime snack. what is the priority for the nurse to assess due to his refusal of a snack?

signs of hypoglycemia earlier than expected

nephropathy

small vessels disease affects the kidneys

A finding of elevated blood glucose levels is :

the basic criterion for the diagnosis of diabetes

How do sulfonylureas act for patients with type 2 diabetes?

act by directly stimulating beta cells of the pancreas to secret insulin (cannot be used in patients with type 1 diabetes)

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

albumin

type 2 diabetes is the 7th leading cause of death and affects

approximately 20% of older adults

gestational diabetes occurs

in as many as 18% of pregnant women and increase their risks for hypertensive disorders during pregancy

the nurse is caring for a patient with a abnormally low blood glucose concentration. what glucose level will the nurse observe when assessing laboratory results?

lower than 50-60 mg/dL