Glucose Regulation
A newborn whose mother has type 1 diabetes is receiving a continuous infusion of fluids with glucose. What should the nurse do when preparing to discontinue the IV?
Decrease the rate slowly.
After a surgical procedure for cancer of the pancreas that included the removal of the stomach, the head of the pancreas, the distal end of the duodenum, and the spleen, the postoperative manifestation by the client that requires immediate attention by the nurse is:
Hyperglycemia
A woman who has gestational diabetes gives birth at term to a large-for-gestational age (LGA) infant weighing 9 lb 6 oz (4250 g). For what complication should the newborn be monitored?
Hypoglycemia
A nurse is educating a client with diabetes about insulin and appropriate nutritional intake. Which statement indicates that the client understands the teaching?
I can eat lots of foods as long as I stick to my exchange units."
A 40-year-old male is prescribed Metformin XL (Glucophage) to control his type 2 diabetes mellitus. Which statement made by this client indicates the need for further education?
I will stop taking Metformin for 24 hours before and after having a test involving dye
A nurse is caring for a client who has a 20-year history of type 2 diabetes. The nurse should assess for what physiological changes that are associated with a long history of diabetes?
Blurry, spotty, or hazy vision
A client has a hypoglycemic reaction to insulin. Which client responses should the nurse document as clinical manifestations of hypoglycemia? Select all that apply .
Pallor Tremors Diaphoresis
An adolescent who has just been found to have type 1 diabetes asks a nurse about exercise. What is the best response by the nurse?
Extra snacks are needed before exercise."
A nurse is reviewing the laboratory report of a 13-year-old child with type 1 diabetes. What test is considered the most accurate in the evaluation of the effectiveness of diet and insulin therapy over time?
Glycosylated hemoglobin
A nurse is caring for several clients with type 1 diabetes, and they each have a prescription for a specific type of insulin. Which insulin does the nurse conclude has the fastest onset of action?
Insulin lisipro-humalog
A client is admitted to the hospital with a diagnosis of diabetic ketoacidosis. What is the initial intervention that the nurse should expect the health care provider to prescribe for this client?ntravenous (IV) fluids
Intravenous (IV) fluids
Which clinical indicators can the nurse expect when assessing a client with Cushing syndrome? Select all that apply .
Lability of mood Slow wound healing
A nurse is teaching a client with hypertension about a sodium-restricted diet. What information should the nurse emphasize?
Liking the taste of table salt is learned but it is not a biological necessity.
A client is diagnosed as having type 2 diabetes, and the health care provider prescribes an oral hypoglycemic. The nurse should include in the teaching plan that people taking oral hypoglycemics:
May subconsciously relax dietary rules to gain a sense of control
When a client is receiving dexamethasone (Decadron) for adrenocortical insufficiency. To monitor for a negative side effect of the medication, the nurse should:
Measure blood glucose levels
A 9-year-old child with type 1 diabetes is hospitalized for insulin dosage regulation. A nurse observes the child sneaking food and trying to talk family members into bringing candy. What action should the nurse take when the child complains of feeling hypoglycemic?
Obtain a blood glucose level
A 14-year-old adolescent with diabetes has been self-administering insulin twice a day.. This morning the parents found their child lethargic and confused. After the adolescent's admission to the emergency department, laboratory testing reveals a hemoglobin A 1c level of 10% and a blood glucose level of 200 mg/dL. What does the nurse suspect as the most likely cause of this client's condition?
Uncontrolled blood glucose level
When assessing the laboratory values of a client with type 2 diabetes, the nurse expects the results to reveal:
Urine negative for ketones and glucose in the blood
Which clinical indicator should the nurse identify as expected for a client with type 2 diabetes?
Urine negative for ketones and hyperglycemia.
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
Reduced insulin production
A client who has acromegaly and insulin-dependent diabetes undergoes a hypophysectomy. The nurse identifies that further teaching about the hypophysectomy is necessary when the client states, "I know I will:
Require larger doses of insulin than I did preoperatively."
A client with a family history of diabetes is concerned about the effects of psychiatric medication on the endocrine system. Which psychotropic medication is most likely to cause metabolic syndrome?
Risperidone (Risperdal)
While hospitalized, a client with diabetes is observed picking at calluses on the feet. The nurse should immediately:
Teach the client the importance of effective foot care
A nurse evaluates that a client with diabetes understands the teaching about the treatment of hypoglycemia when the client says, "If I become hypoglycemic I initially should eat:
Sugar and a slice of bread."
A newborn experiences a hypothermic period while being bathed and having clothing changed. Once the hypothermic episode has been identified and treated, what is the next nursing action?
Feeding the infant
The health care provider prescribes daily fasting blood glucose levels for a client with diabetes mellitus. The goal of treatment is that the client will have glucose levels within the range of:
70 to 105 mg/dL of blood
A 16-year-old adolescent with recently diagnosed type 1 diabetes will receive NPH (Novolin N) insulin subcutaneously. The nurse teaches the adolescent about peak action of the drug and the risk for hypoglycemia. How many hours after the drug does the NPH peak?
4 to 12 hours
A nurse is caring for two clients newly diagnosed with diabetes. One client has type 1 diabetes and the other client has type 2 diabetes. The nurse determines that the main difference between newly diagnosed type 1 and type 2 diabetes is that in type 1 diabetes:
Complications are not present at the time of diagnosis.
A 9-year-old child has the diagnosis of type 1 diabetes. What intervention should be included in the school nurse's plan of care for this child?
Considering the presence of diabetes but treating the child similarly to other children
A nurse who is monitoring the blood glucose level of the term infant of a diabetic mother (IDM) identifies a blood glucose level of 48 mg/dL. What should the nurse do?
Continue to monitor the blood glucose level per policy.
A client with type 2 diabetes is taking one glyburide (Micronase) tablet daily. The client asks whether an extra pill should be taken before exercise. What is the nurse's best reply?
Do not take an extra pill because you may become hypoglycemic when exercising
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
Examine the feet daily, wearing well fitted shoes, performing regular exercise
The nurse is providing teaching to a client who recently has been diagnosed with type 1 diabetes. The nurse reinforces the importance of monitoring for ketoacidosis. What are the signs and symptoms of ketoacidosis? Select all that apply.
Excessive thirst Fruity breath confusion
A client is scheduled to receive 1 L of total parenteral nutrition (TPN) every 12 hours. The primary nursing responsibility is to monitor the client's:
Serum glucose levels
A nurse is caring for a client admitted to the hospital for diabetic ketoacidosis. Which clinical findings related to this event should the nurse document in the client's clinical record? Select all that apply
Acetone breath Decreased arterial carbon dioxide level
What finding in a newborn whose temperature over the last 4 hours has fluctuated between 98.0° F (36.6° C) and 97.4° F (36.3° C) would be considered critical?
Blood glucose level of 36 mg/dL
A client who is feeling increasingly tired seeks medical care. Type 1 diabetes is diagnosed. The nurse explains that the increased fatigue is the result of:
Decreased production of insulin by the pancreas
A client with type 1 diabetes is placed on an insulin pump. The most appropriate short-term goal when teaching this client to control the diabetes is: "The client will:
Demonstrate the correct use of the administration equipment."
A client with post-radiation enteritis is to continue receiving total parenteral nutrition (TPN) at home after discharge. What information should the nurse include in the client's teaching plan?
Demonstrating how to test capillary glucose levels.
A nurse is planning to teach an adolescent about diabetes and self-administration of insulin. What should the nurse do first?
Determine what the adolescent knows about diabetes
A client with diabetes asks how exercise will affect insulin and dietary needs. The nurse should respond, "Exercise:
Increases the need for carbohydrates and decreases the need for insulin."
A nurse plans to teach a school-aged child with type 1 diabetes who is receiving both intermediate-acting insulin (Novolin N) and regular insulin (Novolin R) daily how to self-administer the insulin before discharge. What should the nurse teach the child?
Practice using the nonmedicated insulin pen first
