Chapter 51 - Diabetes

The nurse is preparing to administer IVF for a patient with DKA who has a history of hypertension and CHF. What order for fluids would the nurse anticipate infusing for this patient?

0.45% normal saline

A patient is diagnosed with Type 1 Diabetes. What clinical characteristics does the nurse expect to see in this patient? (Select all that apply)

1 Ketosis prone 2 Little endogenous insulin 3 Younger than 30 years of age

The nurse is assessing a patient with non proliferative (background) retinopathy. When examining the retina, what would the nurse expect to see? (Select all that apply.)

1 Leakage of fluid or serum (exudates) 2 Microaneurysms 3 Focal capillary single closure

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? (Select all that apply)

1 May improve blood glucose levels 2 Decrease the need for exogenous insulin 3 Help reduce cholesterol levels

In the US, diabetes is the leading cause of ___________, ____________ and _____________.

1 Non-traumatic amputation 2 Blindness 3 End state Kidney Disease

Classic clinical manifestations of diabetes include the "three P's":

1 Polyuria 2 Polydipsia 3 Polyphagia

The major classifications of Diabetes are:

1 Type 1 2 Type 2 3 Gestational

A female diabetic patient who weighs 130 pounds has an ideal body weight of 116 pounds. For weight reduction of 2 lbs/week, approx. what should be her ideal caloric intake?

1000 calories

Goals for blood glucose levels during pregnancy are ______ or less BEFORE meals and _______ or less 2 hours after meals.

105mg/dL, 130mg/dL

Gestational diabetes occurs in as many as ___% of pregnant women and increases their risk for hypertensive disorders during pregnancy

18

A woman at average risk for the development of hyperglycemia during pregnancy should be tested at _________ weeks

24-28 weeks

It is estimated that more than ___ million people in the US have diabetes, although almost 1/3 of these cases are undiagnosed

25.8

The nurse expects that a type 1 diabetic patient may receive what % of his or her usual morning dose of insulin postoperatively?

50-60%

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

Albumin

The nurse is educating the patient about the benefits of fruit versus fruit juice in the diabetic diet. The patient states "What difference does is make if you drink the juice of eat the fruit? It is all the same." What us the best response by the nurse?

Eating the fruit instead of drinking the juice decreases the glycemic indies by slowing the absorption

A finding of _______________________ is the basic criterion for the diagnosis of diabetes

Elevated blood glucose levels

New glucose is produced from amino acids.

Gluconeogenesis

Filtered glucose that the kidney cannot absorb spill over into the urine.

Glucosuria

Glycogen breaks down in the liver through the action of glucagon

Glycogenolysis

__________, ___________, and ___________ ____________ are the three metabolic derangements that occur in DKA.

Hyperglycemia, ketosis, metabolic acidosis

An older adult patient is in the hospital being treated for sepsis related to a UTI. 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

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

Hypoglycemia

Uncontrolled type 2 diabetes may lead to an acute problem:

Hypoglycemic-hyperosmolar syndrome

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

Hypokalemia

The nurse is caring for a patient with an abnormally low blood sugar concentration. What glucose level will the nurse observe when assessing lab results?

Lower than 50-60 mg/dL

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

NPH

Small vessel disease affects the kidneys

Nephropathy

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

Osmotic diuresis

An older adult patient that has diabetes type 2 comes to the ED with second degree burns to the bottom of both feet and states "I didn't feel too hot but my feet must have been too 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 DKA. What insulin does the nurse know is the only one that can be used via IV

Regular

Microvascular changes develop in the eyes

Retinopathy

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

Reviewing the patients diet history to identify eating habits and lifestyle and cultural eating patterns

Type 2 Diabetes is the ___________ leading cause of death and affects approx. ____% of older adults

Seventh, 20%

Insulin refers to a ____________ tissue sensitivity to insulin

decreased

Because insulin normally inhibits _______________ & ______________, these processes occur in an unrestrained fashion in people with insulin deficiency and contribute further to hyperglycemia.

glycogenolysis & gluconeogenesis