Endocrine Med-Surg

What are the blood glucose levels for hypoglycemia?

<70 mg/dL

What are the blood glucose levels for hyperglycemia?

>200 mg/dL

A nurse is providing teaching to a client who has type 2 diabetes mellitus about the pathophysiology of the disease. Which of the following statements by the client indicates an understanding of the teaching? A. "My cells are resistent to the effects of insulin." B. "My body breaks down sugar too efficiently." C. "My pancreas doesn't produce insulin." D. "My body produces antibodies against pancreatic beta cells."

A. "My cells are resistant to the effects of insulin." Rationale: A client who has type 2 diabetes mellitus will have resistance to insulin and a decrease in the secretion of insulin by the pancreatic beta cells.

A nurse is checking laboratory values to determine if a client with diabetes mellitus is adhering to the treatment plan. Which of the following tests should the nurse use to make this determination? A. Glycosylated hemoglobin levels (HbA1c) B. Urine sugar and acetone levels C. Glucose tolerance tests D. Fasting serum glucose

A. Glycosylated hemoglobin levels Rationale: checking glycosylated hemoglobin levels (HbA1c) is an accurate method of determining if the client is routinely compliant. Glycosylated hemoglobin refers to hemoglobin connected to glucose. Since the lifespan of an RBC is 4 months, this value is not affected by recent changes in the client's diet or medication.

A nurse is providing teaching about exercise to a client who has type 1 diabetes mellitus. Which of the following statements should the nurse include? A. "You should exercise during peak insulin times." B. "Wear a medical alert ID tag when you exercise." C. "Exercise can decrease the effects of insulin and can cause your blood glucose levels to increase." D. "You will get the most benefit from exercise when your glucose levels are higher than normal."

B. "Wear a medical alert ID tag when you exercise." Rationale: The client should wear a medical alert identification tag in the event of a hypoglycemic response because exercise can potentiate the effects of insulin and cause blood glucose levels to decrease.

A nurse is planning discharge teaching for a patient who has diabetes mellitus. Which of the following actions should the nurse plan to take first? A. Obtain sample menus from the dietitian to give to the client B. Ask the client to identify the types of foods she prefers C. Identify the recommended range of the client's blood glucose levels D. Discuss long-term complications that can result from non-adherence to the dietary plan

B. Ask the client to identify the types of foods she prefers Rationale: The nurse should apply the priority setting framework to plan the client care and prioritize nursing actions. Involving the client in planning will promote her adherence to the dietary plan

A nurse is caring for a client who has type 1 diabetes mellitus and a capillary blood glucose of 48 m/dL. Which of the following findings should the nurse expect? A. Kussmaul respirations B. Diaphoresis C. Decreased skin turgor D. Ketouria

B. Diaphoresis Rationale: A client who has a blood glucose level below 70 mg/dL will exhibit manifestations of hypoglycemia. Expected findings associated with hypoglycemia include weakness, hunger, diaphoresis, nausea, shakiness, and confusion.

A nurse is caring for a client who has type 2 diabetes melterm-5litus and is displaying manifestations of hyperglycemia. Which of the following indicates the client has hyperglycemia? A. Hunger B. Increased Urination C. Cold, clammy skin D. Tremors

B. Increased Urination Rationale: Increased urination is a manifestation of hyperglycemia due to a deficiency of insulin, which can lead to osmotic diuresis.

A nurse is teaching a client who has hyperthyroidism about managing this disorder. Which of the following recommendations should the nurse include? A. Reduce total hours of sleep B. Keep the immediate environment warm C. Increase caloric intake with meals D. Gradually increase activity

C. Increase caloric intake with meals Rationale: clients whose thyroid hormone levels are high have increased protein, lipid, and carb metabolism. This results in the loss of protein stores and negative nitrogen balance. Even with an increased appetite, meeting energy demands is often difficult, and weight loss is common. Muscle weakness & wasting can develop without adequate caloric and protein intake.

What are the signs and symptoms of hypoglycemia?

Cool and clammy skin, confusion, fatigue & weakness, palpitations, shakiness, headache, inability to arouse from sleep (can lead to coma)

A nurse is providing teaching about food choices to a client who has diabetes mellitus. Which of the following statements by the client indicates an understanding of the teaching? A. " I will need to eliminate sweet desserts from my diet." B. " I should avoid using sucralose in my coffee." C. "I should consume alcohol between meals in moderation." D. " I should replace white bread with whole-grain bread."

D. " I should replace white bread with whole-grain bread." Rationale: Clients with diabetes have the same fiber requirements as the general population. Fiber content can be increased by substituting white bread, which is made with refined grains, with whole-grain bread, which retains the outer layer of the grain that is higher in fiber.

A nurse is reviewing the laboratory results of a client who has diabetes mellitus. Which of the following results indicates that the client's diabetes is controlled? A. HbA1c 8.5% B. Postprandial blood glucose 190 mg/dL C. Casual blood glucose 205 mg/dL D. Fasting blood glucose 95 mg/dL

D. Fasting blood glucose 95 mg/dL Rationale: A fasting blood glucose of 95 mg/dL is withing expected reference range of 70-110 mg/dL which indicates that the client's diabetes is under control.

A nurse is planning care for a client who is experiencing the Somogyi effect and takes intermittent-acting insulin. Which of the following actions should the nurse include in the plan? A. Move the evening intermittent-acting insulin dose to 90 min before dinner B. Increase the client-s morning caloric intake C. Omit the client's evening snack D. Monitor the client's nighttime blood glucose levels

D. Monitor the client's nighttime blood glucose levels Rationale: The Somogyi effect describes a high blood glucose level in the morning after an extremely low blood glucose level during the night. This swing is caused by the release of stress hormone to counter low glucose levels. Monitoring the nighttime blood glucose levels over time can provide an accurate diagnosis of the Somogyi effect.

What are signs and symptoms of hyperglycemia?

polydipsia, polyuria, polyphagia, Hot & dry skin, fruity breath, dry mouth (dehydration), deep & rapid breaths, numbness & tingling, slow wound healing, vision changes