Diabetes 2 (Nurs 309):

A client with type I diabetes has an above the knee amputation because of severe lower extremity arterial disease. What is the nurse's primary responsibility 2 days after surgery when preparing the client to eat dinner? 1. Checking the client's serum glucose level. 2. Assisting the client out of bed into a chair. 3. Placing the client in the high-fowler's position. 4. Ensuring the client's residual limb is elevated.

1. Checking the client's serum glucose level.

A nurse is formulating a teaching plan for a client recently diagnosed with type 2 diabetes. What interventions should the nurse include that will decrease the risk of complications? (Select all that apply.) 1. Examining the feet daily. 2. Wearing well-fitting shoes. 3. Performing regular exercise. 4. Powdering the feet after showering. 5. Visiting the health care provider weekly. 6. Testing bathwater with the toes before bathing.

1. Examining the feet daily. 2. Wearing well-fitting shoes. 3. Performing regular exercise.

The UAP reports to the RN that a patient with type I diabetes has a question about exercise. What important points would the RN be sure to teach this patient? Select All That Apply. 1. Exercise guidelines are based on blood glucose and urine ketone levels. 2. Be sure to test your blood glucose only after exercising. 3. You can exercise vigorously if your blood glucose is between 100 and 250 mg/dL. 4. Exercise will help resolve the presence of ketones in your urine. 5. A 5-10 minute warm-up and cool-down period should be included in your exercise. 6. For unplanned exercise, increased intake of carbohydrates is usually needed.

1. Exercise guidelines are based on blood glucose and urine ketone levels. 3. You can exercise vigorously if your blood glucose is between 100 and 250 mg/dL. 5. A 5-10 minute warm-up and cool-down period should be included in your exercise. 6. For unplanned exercise, increased intake of carbohydrates is usually needed.

The nurse is caring for an 81-year old adult with type II diabetes, hypertension, and peripheral artery disease. Which admission assessment findings increase the patient's risk for development of hyperglycemic hyperosmolar nonketotic syndrome? Select All That Apply. 1. Hydrochlorothiazide prescribed to control her blood pressure. 2. Weight gain of 6 lb over the past month. 3. Avoid consuming liquids in the evening. 4. Blood pressure of 168/94. 5. Urine output of 50-75 mL/hr. 6. Glucose greater than 600 mg/dL.

1. Hydrochlorothiazide prescribed to control her blood pressure. 3. Avoid consuming liquids in the evening. 6. Glucose greater than 600 mg/dL.

An older patient with type II diabetes has cardiovascular autonomic neuropathy. Which instruction would the nurse provide for the UAP assisting the patient with morning care? 1. Provide a complete bed bath for this client. 2. Sit the patient up slowly on the side of the bed before standing. 3. Only let the patient was his or her face and brush his or her teeth. 4. Be sure to provide rest period between activities.

1. Provide a complete bed bath for this client.

The plan of care for a patient with diabetes includes all of these interventions. Which intervention should the nurse delegate to the UAP? 1. Reminding the patient to put on well-fitting shoes before ambulating. 2. Discussing community resources for diabetes outpatient care. 3. Teaching the patient to perform daily foot inspection. 4. Assessing the patient's technique for drawing insulin into a syringe.

1. Reminding the patient to put on well-fitting shoes before ambulating.

The RN is serving as a preceptor to a new graduate nurse who has recently passed the RN licensure exam. The new nurse has only been on the unit for 2 days. Which patient should be assigned to the new graduate nurse? 1. A 68-year old patient with diabetes who is showing signs of hyperglycemia. 2. A 58-year old patient with diabetes who has cellulitis of the left ankle. 3. A 49-year old patient with diabetes just returned from the PACU after a below the knee amputation. 4. A 72-year old patient with diabetes with diabetic ketoacidosis who is receiving IV insulin.

2. A 58-year old patient with diabetes who has cellulitis of the left ankle.

Which nursing intervention is the priority when a client is first admitted with hyperglycemic hyperosmolar nonketotic syndrome? 1. Providing oxygen. 2. Encouraging carbohydrates. 3. Administering fluid replacement. 4. Teaching facts about dietary principles.

3. Administering fluid replacement.

A nurse is caring for two clients newly diagnosed with diabetes. One client has Type I diabetes and the other client has Type II diabetes. The nurse determines that the main difference between newly diagnosed Type I and Types II diabetes is that type I diabetes: 1. Onset of the disease is slow. 2. Excessive weight is a contributing factor. 3. Complications are not present at the time of diagnosis. 4. Treatment involves diet, exercise, and oral medications.

3. Complications are not present at the time of diagnosis.

A nurse is assessing a client experiencing a diabetic coma. What unique response associated with diabetic coma that is not exhibited with hyperglycemic hyperosmolar nonketotic syndrome should the nurse identify when assessing the client? 1. Fluid loss. 2. Glycosuria. 3. Kussmaul respirations. 4. Increased blood glucose levels.

3. Kussmaul respirations.

Metformin (Glucophage) 2 g by mouth is prescribed for a client with Type II diabetes. Each tablet contains 500 mg. How many tablets should the nurse administer? Record your answer using a whole number.

4 tablets.

A client with diabetes is given instructions about foot care. The nurse determines that the instructions are understood when the client states, "I will: 1. Cut my toenails before bathing." 2. Soak my feet daily for one hour." 3. Examine my feet using a mirror at least once a week." 4. Break in my new shoes over the course of several weeks."

4. Break in my new shoes over the course of several weeks."

A UAP tells the nurse that while assisting with the morning care of a postoperative patient with type II diabetes who has been given insulin, the patient asked if she will always need to take insulin now. What is the RN's priority for teaching the patient? 1. Explain to the patient that she is now considered to have type I diabetes. 2. Tell the patient to monitor fingerstick glucose level every four hours after discharge. 3. Teach the patient that a person with type II diabetes does not always need insulin. 4. Discuss the relationship between illness and increased glucose levels.

4. Discuss the relationship between illness and increased glucose levels.

A client tells the nurse during the admission history that an oral hypoglycemic agent is taken daily. For which condition does the nurse conclude that an oral hypoglycemic agent may be prescribed by the health care provider? 1. Ketosis. 2. Obesity. 3. Types 1 diabetes. 4. Reduced insulin production.

4. Reduced insulin production.