Glucose Regulation
A nurse is educating a client newly diagnosed with diabetes mellitus about exercise. Which statements by the client demonstrate understanding? Select all that apply. "Exercise may decrease the risk of heart disease." "Exercise has no effect on blood glucose levels." "It is important to wear properly fitting footwear." "Exercise is best done after meals when blood glucose is higher." "It is important to stay hydrated and monitor blood glucose." "Exercise must be vigorous to be effective."
"Exercise may decrease the risk of heart disease." "It is important to wear properly fitting footwear." "Exercise is best done after meals when blood glucose is higher." "It is important to stay hydrated and monitor blood glucose."
The nurse educates a teenage client newly diagnosed with diabetes mellitus that requires insulin injections. Which statements by the client demonstrate understanding? Select all that apply. "I can eat what I want as long as I take insulin to cover the carbohydrates." "My family needs to know how to deliver my insulin if I'm not able." "I will hold my insulin if I become sick and cannot eat." "I will need to drop out of sports until my blood glucose is under better control." "If I lose weight, I'll be able to stop taking insulin." "I will monitor my A1C monthly." "I should carry some sugar-free hard candies in case my glucose level drops." "I will dispose of my capped syringes in the trash can." "I will test my blood glucose throughout the day before taking the insulin."
"I can eat what I want as long as I take insulin to cover the carbohydrates." "My family needs to know how to deliver my insulin if I'm not able." "I will test my blood glucose throughout the day before taking the insulin."
A nurse is educating a client with diabetes mellitus on insulin injections. Which response by the client indicates a correct understanding of the teaching? "I will draw up cloudy before clear insulin." "I will cleanse the site and rotate injection sites." "I will hold insulin when I am sick." "I will throw away capped syringes and needles in the trash."
"I will cleanse the site and rotate injection sites."
The nurse assesses a client admitted with hyperglycemia that has a 20-year history of diabetes mellitus. Review the nurses' note and highlight the one finding that is most concerning. Nurses' Note 1.Blood glucose: 243 mg/dL. Insulin given as prescribed per sliding scale. 2.Blood urea nitrogen (BUN) level: 26 mg/dL. Reference (10-20 mg/dL) 3.Glomerular filtration rate (GFR): 35 mg/mmol. Reference (90-120 mg/mmol) 4.Urine output: 100 mL over 6 hours. 5.Pea-sized wound on the right heel.
4.Urine output: 100 mL over 6 hours.
A nurse is caring for a client who was just admitted to the emergency department after fainting while exercising. The client is lethargic and the serum blood glucose level is 62 mg/dL. What orders should the nurse anticipate? Select all that apply. Initiate hyperglycemic hyperosmolar syndrome (HHS) protocol Administer regular insulin intravenous Administer dextrose 50% intravenously Initiate intravenous access Recheck blood glucose level in 30 minutes Administer 15 grams dextrose orally
Administer dextrose 50% intravenously Initiate intravenous access
A nurse is caring for a client with type I diabetes who has poor glycemic control. For each client finding, click to specify if the finding is consistent with the complications of chronic kidney disease, retinopathy, neuropathy, or coronary artery disease. Chest pain and fatigue Blindness or poor vision Numbness and tingling Increased risk of wounds Decreased glomerular filtration rate (GFR), urine output less than 30 mL/hour
CAD Retinopathy Neuropathy Neuropathy CKD
The nurse assesses several clients with diabetes mellitus. Select the priority action for each client. Client 1 - Cool to touch and clammy, alert but "feels strange." Obtain a bedside glucose level Deliver meal tray and encourage eating Deliver dextrose 50% IV Client 2 - Shaking, confused, uncooperative Deliver insulin per sliding scale Obtain a bedside glucose level Deliver dextrose 50% IV Client 3 - Increased urination and thirst over the last 3 hours Evaluate for acidosis Deliver IV fluid replacement Obtain a bedside glucose level
Client 1 - Obtain bedside glucose level Client 2 - Deliver dextrose 50% IV Client 3 - Obtain bedside glucose level
The nurse assesses a client admitted with diabetes mellitus type 1. The client is diaphoretic, tachycardic, confused about place and time, and combative. Click to specify if each action should be performed immediately, within 15 minutes, or is contraindicated. Check urine for ketones Check blood glucose Give 15 grams of glucose tablets as prescribed Give dextrose 50% as prescribed Recheck blood glucose
Contraindicated Immediately Contraindicated Immediately Within 15 min
A nurse is caring for a client who presents to the emergency department with symptoms of confusion, dehydration, deep rapid respirations, and fruity breath. Complete the sentence using the drop-down options. The client is experiencing _________ and should be treated with _______ .
DKA regular insulin IV
The nurse is caring for a teenage client in the emergency department with confusion, dry mucous membranes, and deep rapid respirations. The heart rate and blood pressure are consistent with dehydration, and the bedside blood glucose is 425 mg/dL. Complete the sentence using the drop-downs provided. The client is experiencing _________ and should be treated with ________ and _______.
DKA regular insulin IV push Sodium chloride IV bolus
The nurse educates a group of clients newly diagnosed with diabetes mellitus about the signs and symptoms of diabetic ketoacidosis (DKA) and hyperglycemic hyperosmolar syndrome (HHS). For each teaching topic, identify the presenting symptoms to include with teaching. Select one or more answers for each complication. Not all presenting symptoms may be used.
DKA: Fast, deep breathing Increased thirst Confusion Dry, hot skin HHS: Fever Syncope Frequent urination
A nurse is educating a client about hyperglycemic hyperosmolar syndrome (HHS) manifestations. Which symptoms should the nurse include in the teaching? Bradycardia and hypertension Dehydration, thirst, and muscle cramps Cool, clammy skin and confusion Kussmaul's respirations and fruity breath
Dehydration, thirst, and muscle cramps
The nurse prepares a teaching session with a client who is learning how to self-inject insulin. Rearrange the nurse's actions in the order in which they should be performed.
Determine if the client is rested, comfortable, and ready to learn. Evaluate what the client knows and understands about self-injection of insulin. Explain the process of insulin preparation and injection. Demonstrate insulin preparation and injection. Ask the client to perform insulin preparation and injection. Clarify and summarize what was learned.
A nurse is working with an unlicensed assistive personnel (UAP) to care for a client with diabetes mellitus. Which should the nurse delegate to the UAP? Select all that apply. Show the client how to administer insulin. Perform a focused assessment. Assess for acute complications. Gather supplies, including a glucometer. Evaluate blood glucose results and trends. Deliver the meal tray on time.
Gather supplies, including a glucometer. Deliver the meal tray on time.
A nurse is caring for a client receiving insulin via a titrating infusion. Review the trending data and highlight the one entry that requires immediate action. Nurses' Notes 0815 Glucose 479 mg/dL, insulin infusion at 6 units/hr, 0.9% NaCl infusing at 250 mL/hr, respiratory rate 26 breaths/min, BP 110/67 mmHg. 0910 Glucose 372 mg/dL, insulin infusion at 6 units/hr, 0.9% NaCl infusing at 250 mL/hr, respiratory rate 24 breaths/min, BP 112/65 mmHg. 1018 Glucose 350 mg/dL, insulin infusion at 5 units/hr, 0.9% NaCl infusing at 150 mL/hr, respiratory rate 22 breaths/min, BP 120/72 mmHg. 1105 Glucose 301 mg/dL, insulin infusion at 5 units/hr, 0.9% NaCl infusing at 150 mL/hr, respiratory rate 20 breaths/min, BP 115/70 mmHg.
Glucose 372 mg/dL, insulin infusion at 6 units/hr, 0.9% NaCl infusing at 250 mL/hr, respiratory rate 24 breaths/min, BP 112/65 mmHg.
A nurse is providing discharge education to a client with diabetes mellitus about the symptoms and treatment of acute hypoglycemia. Select whether each teaching point is indicated or contraindicated in the management of hypoglycemia. Always keep hard sugar candy or a simple carbohydrate with you. Test blood glucose each time before taking insulin. Do not exercise at all if you have diabetes. If you have low blood glucose, eat sugar-free or complex carbohydrate snacks. If your blood glucose is low and you are still alert, eat 15 grams of simple carbohydrates, then re-check blood glucose in 15 minutes. Do not eat before or during exercise. It is okay to skip meals to help with weight loss.
Indicated Indicated Contraindicated Contraindicated Indicated Contraindicated Contraindicated
A nurse enters a client's room and notices the client is sleepy, irritable, lethargic, and not following commands. The blood glucose is 58 mg/dL. What are the priority actions of the nurse? Select all that apply. Recheck blood glucose after 15 minutes Administer 15 grams of glucose orally Administer regular insulin intravenously Assess feet for wounds Administer 50% dextrose intravenously Check urine for ketones
Recheck blood glucose after 15 minutes Administer 50% dextrose intravenously
The nurse cares for a client with years of poorly controlled diabetes mellitus. Identify each finding as related or unrelated to the condition. Select one answer in each row. Weight loss of 10 pounds a year Cold feet and need for heavy socks Slow healing wounds Blurred vision Hypotension Decreased glomerular filtration rate Elevated liver function enzymes
Unrelated Related Related Related Unrelated Related Unrelated
The nurse is notified by the unlicensed assistive personnel (UAP) that a client with diabetes mellitus is acting strangely and refusing to have their blood pressure taken. The nurse remembers that the client refused to eat lunch. Complete the sentence using the drop-downs. The nurse should ask the UAP to ________ while the nurse ______.
bring the bedside glucose monitor to the room performs a focused assessment
A nurse is caring for a client with type I diabetes and monitoring the client for potential complications. From the drop-down menu, select the symptom that best matches the potential complication. The client reports ________ which are expected manifestations of ________.
increased thirst and urination hyperglycemia
