Patho Exam 4 Ch 33

Research has identified a cycle of insulin-induced posthypoglycemic episodes. What is this phenomenon called?

Somogyi effect.

Which of the following criteria about insulin would prompt a diagnosis of type 1 diabetes?

Complete failure of insulin secretion.

A 23-year-old man is admitted to the hospital. He is experiencing polyphagia, polyuria, and polydipsia. He states that the condition has come on very suddenly. The client is likely to require what treatment?

Exogenous insulin injections.

A client tells the health care provider that he has been very compliant over the last 2 months in the management of his diabetes. The best diagnostic indicator that would support the client's response would be:

Glycosylated hemoglobin, hemoglobin A1C (HbA1C).

What are the hallmark signs of diabetes mellitus?

Polyuria, polydipsia, and polyphagia.

A client diagnosed with type 2 diabetes has been instructed about managing his condition with diet. The nurse determines further teaching is necessary when the client states:

"I must avoid all candies and cookies, but can eat unlimited amounts of pasta and breads."

The health care provider has prescribed Repaglinide 2 mg for a client diagnosed with type 2 diabetes. The most important information for the nurse to give the client would be:

"Take the medication 15 to 30 minutes before each meal."

A three year-old girl has just been diagnosed with type 1A diabetes. Her parents are currently receiving education from the diabetes education nurse. How can the nurse best explain to the parents the etiology (cause) of their daughter's diabetes?

"The problem that underlies her diabetes is that her own body has destroyed the cells in her pancreas that produce insulin."

The critical care nurse has just admitted a client with diabetic ketoacidosis (DKA) whose blood glucose level is 877 mg/dL. The client's breath has a fruity odor and the client is confused. Which of these does the nurse set as the priority at this time?

Administration of intravenous fluids.

When educating a patient about glargine (Lantus), the nurse should explain that this medication:

Has a prolonged absorption rate and provides a relatively constant concentration for 12-24 hours.

A man is brought into the emergency department by paramedics who state that the client passed out on the street. The man smells of alcohol, and when roused says he has not eaten since yesterday. He is wearing a medic alert bracelet that says he is a diabetic. What would the nurse suspect as a diagnosis?

Hypoglycemia.

Select the most appropriate intervention for the nurse to teach a client diagnosed with distal symmetric neuropathy related to diabetes.

Inspect the feet for blisters daily.

The diagnosis of type 1 diabetes would be confirmed by:

Insulin is not available for use by the body.

A client with severe hypoglycemia is unconscious. Which method of providing glucose should be avoided?

Orange juice orally.

A woman with a diagnosis of type 2 diabetes has been ordered a hemoglobin A1C test for the first time by her primary care provider. The woman states, "I don't see why you want to test my blood cells when its sugar that's the problem." What aspect of physiology will underlie the care provider's response to the client?

The amount of glucose attached to A1C cells reflects the average blood glucose levels over the life of the cell.

The nurse is teaching a client with diabetes and the family about the signs and symptoms of hypoglycemia. The client asks what produces signs and symptoms of headache, disturbed behavior, coma, and seizures. The best response would be:

The brain relies on blood glucose as its main energy source.

A nurse educator is conducting a course for newly diagnosed diabetes clients. Which statement by participants should the nurse follow up first?

"I've had a little sore on the sole of my foot for a few days, but I'm sure it will eventually heal."

The nurse is reviewing assessment data on four clients. Select the client at highest risk for developing type 2 diabetes.

A 45-year-old obese female with a sedentary lifestyle.

A nurse is evaluating patients for the risk of developing type 2 diabetes. Which of the following patients has the highest risk?

A 45-year-old obese woman with a sedentary lifestyle.

A 60 year-old man has long managed his type 1 diabetes effectively with a combination of vigilant blood sugar monitoring, subcutaneous insulin administration and conscientious eating habits. This morning, however, his wife has noted that he appears pale and clammy and appears to be in a stupor, though he is responsive. She suspects that he has made an error in his insulin administration and that he is experiencing a hypoglycemic episode. Which of the following actions should be the wife's first choice?

Administration of 15 to 20 g of glucose in a concentrated carbohydrate source.

Hypoglycemia has a sudden onset with a progression of symptoms. What are the signs and symptoms of hypoglycemia?

Altered cerebral function and headache.

The pancreas is an endocrine organ that is composed of the acini and the islets of Langerhans. The islets of Langerhans have alpha, beta, and delta cells as well as the PP cell. Which cells secrete insulin?

Beta cells.

The nurse and nursing student are caring for a client undergoing a severe stressor with release of epinephrine into the bloodstream. Which of these effects on blood glucose levels does the nurse teach the student epinephrine will cause?

Blood glucose will elevate.

The diabetes nurse educator is teaching a community education class for new diabetics. Which of these does the nurse include in the discussion of signs and symptoms of hyperglycemia? Select all that apply.

Blurred vision, weight loss, and thirst.

A patient is diagnosed with metabolic syndrome. Frequent concomitants of this syndrome include which of the following? Select all that apply.

Body mass index (BMI) greater than 30, Elevated fasting blood glucose (FBG), Coronary artery disease, and Hypertriglyceridemia.

When caring for the client with diabetic ketoacidosis, the nurse recognizes that fatty acids and ketones may be used for energy by most organs. Which of these organs does the nurse recognize is reliant on glucose as the major energy source?

Brain.

Peripheral neuropathies occur in people with diabetes mellitus. With the loss of sensation in the lower extremities, diabetics become predisposed to what?

Clawing of toes and denervation of the small muscles of the foot.

For which conditions is diabetes mellitus a risk factor? Select all that apply.

Coronary artery disease, Cerebrovascular accident, and Chronic kidney disease.

A patient with diabetes is being evaluated for the disease's potential chronic complications. The nurse knows that a patient with distal symmetric neuropathy will have which of the following signs and symptoms? Select all that apply.

Decreased pain perception, Risk for falling, Stocking-glove pattern function loss, and Risk of foot injuries.

Diabetics are hospitalized for a number of reasons. What is the most common complication of diabetes requiring hospitalization?

Foot problems.

The nurse is caring for a client who received regular insulin at 7 am. Four hours later the nurse finds the client diaphoretic, cool, and clammy. Which of these interventions is the priority?

Give the client a concentrated carbohydrate.

A patient with diabetes asks the nurse for advice in controlling between-meal blood glucose levels. Which of the following might the nurse suggest as a long-acting insulin to provide a consistent basal level?

Glargine (Lantus).

Which of the following interventions is important for the nurse to teach a patient diagnosed with distal symmetric neuropathy related to diabetes? Select all that apply.

Inspect the feet daily for blisters, and wear well-fitted shoes.

A client is admitted to the emergency department and diagnosed with diabetic ketoacidosis (DKA). The client would most likely manifest:

Ketosis.

The nurse has just completed teaching a client newly diagnosed with type 1 diabetes about rapid-acting insulin. The nurse determines that teaching was effective when the client selects:

Lispro.

A client with diabetes mellitus arrives at the hospital with a blood glucose level of 639 mg/dl. What assessment data would indicate type 2 diabetes mellitus rather than type 1?

Negative ketones in urine.

A client admitted to the hospital with elevated blood glucose is diagnosed with type 1 diabetes mellitus. What characteristics commonly differentiate type 1 diabetes mellitus from type 2 diabetes mellitus? Select all that apply.

Onset before age 20, Autoimmune beta cell damage, and Abrupt onset of symptoms.

A male patient is being evaluated for metabolic syndrome. Which of the following are diagnostic criteria for this syndrome? Select all that apply.

Patient's body mass index (BMI) is 31, Patient's high-density lipoprotein (HDL) cholesterol is 25, and Patient's blood pressure (BP) is 150/90 mm Hg.

Select the most common symptoms of diabetes. Select all that apply.

Polydipsia, Polyuria, and Polyphagia.

The nurse knows that increased blood glucose levels will pull water out of cells and result in which of the following? Select all that apply.

Polydipsia, and Polyuria.

A woman in her 28th week of pregnancy tests positive for gestational diabetes mellitus and begins to follow a nutritional plan at home. What result at the follow-up visit indicates a successful outcome?

Random blood glucose 85 mg/dl.

A client with diabetes carries insulin with him at all times. At 11:35, he obtains a blood glucose reading of 12.1 mmol/l and self-administers a dose of insulin in anticipation of eating lunch at noon. What type of insulin did he most likely inject?

Short acting.

A client is managing his diabetes with exercise and diet. The health care provider reviews the client's most recent lab results: fasting blood sugar level at 80 mg/dL and a hemoglobin A1C of 5%. Select the response that best identifies the client.

The client is achieving normal glycemic control.

A client with type 1 diabetes mellitus wishes to stop taking insulin injections. What option is appropriate?

Using an insulin infusion pump.

The nurse is caring for a client with diabetes who has developed gastroparesis. Which of these symptoms does the nurse expect the client to report?

Vomiting after eating.

The obstetrical nurse is caring for a client who has been treated for gestational diabetes. When teaching the client about the causes of gestational diabetes, the nurse should include which of these risk factors in the teaching?

Woman with a family history of diabetes.