Diabetes
Which of the following patients is at most risk for Type 2 Diabetes?
A) a 6 y.o. girl recovering from a viral infection with a family history of diabetes
B) A 28 y.o. male with a BMI of 49
C) A 76 year old female with a history of cardiac disease
D) None of the options provided
B) A 28 y.o. male with a BMI of 49
The ____ _____ secrete insulin which are located in the _______.
A) Alpha cells, liver
B)Alpha cells, pancreas
C) Beta cells, liver
D) Beta cells, pancreas
D) Beta cells, pancreas
The healthcare provider is caring for a patient who has diabetes and is also diagnosed with hypertension. Which of the following medications on the patient's MAR will cause the most concern?
A) Calcium Channel Blocker
B) Beta-Blocker
C) Angiotensin Receptor Blocker
D) ACE inhibitor
B) Beta-Blocker
True or False: Peripheral arterial disease leads to a decrease in rich oxygenated blood being delivered to the lower extremities, which leads to ischemia and necrosis of skin tissue
True
True or False: Peripheral venous disease can occur due to narrowing of the valves in the veins of the lower extremities.
False
The healthcare provider is teaching a group of students about the characteristics of Type 1 Diabetes. Which of the following describe the underlying cause of the disease?
A) Increased hepatic glycogenesis
B) Cellular resistance to insulin
C) Destruction of pancreatic beta cells
D) Atrophy of pancreatic alpha cells
C) Destruction of pancreatic beta cells
A healthcare provider is assessing the glucose level of a patient with a diagnosis of diabetes. Which of the following is most helpful in evaluating this patient's long term glucose management?
A) Fasting blood glucose level
B) Hemoglobin A1c
C) Urine specific gravity
D) The patient's food diary
B) Hemoglobin A1c
Name the rapid-acting insulins along with their onset, peak, and duration.
Insulin glulisine (Apidra)
Insulin lispro (Humalog)
Insulin aspart (Novolog)
Onset: less than 15 min
Peak: 1-2 hours
Duration: 3-4 hours
The MOST common cause of peripheral arterial disease is _____?
A) Diabetes
B) Deep vein thrombosis
C) Atherosclerosis
D) Pregnancy
C) Atherosclerosis
Your patient reports experiencing dull and achy sensations in the lower extremities. You note that the lower extremities have edema and brownish pigmentation. Pulses are present bilaterally and the extremities feel warm to the touch. To help alleviate the patient’s symptoms, the nurse will position the lower extremities in the?
A) Dependent position
B) Horizontal position
C) Elevated position above heart level
D) Knee-flexed position
C) Elevated position above heart level
Name 3 sick day rules for a patient with diabetes.
Never stop taking insulin or oral antidiabetic agents
Measure blood glucose more frequently
Test urine for ketones (if BG is greater than 240)
Drink plenty of liquids
A patient who has diabetes is NPO as prep for surgery. The patient states they feel like their blood suger is low. You check the glucose and find it to be 52. The next nursing intervention would be to:
A) Administer Dextrose 50% IV per protocol
B) Continue to monitor the glucose
C) Give the patient 4 oz of fruit juice
D) None, this is a normal blood glucose reading.
A) Administer Dextrose 50% IV per protocol
What is the onset, peak, and duration of insulin glargine (Lantus)?
Onset: 3-4 hours
Peak: none
Duration: 24 hours
If a patient develops Raynaud's disease what color order will the fingers and toes appear?
White, Bluish-purple, then red.
What are the three parts to Virchow's Triad?
Venous Statsis
Blood Vessel Damage
Increased Blood Clotting Tendency
How will a patient appear if they are hypoglycemic?
Patient will experience: hunger, nuasea, anxiety, pale cool skin, sweating, rapid pulse, hypotension, shakiness, irritability.
A diabetic patient has the following presentation: unresponsive to voice or touch, tachycardia, diaphoresis, and pallor. Which of the folowing actions by the healthcare provider is the priority?
A) Send blood to the lab for analysis
B) Administer the prescribed insulin
C) Administer oxygen per nasal cannula
D) Administer 50% dextrose IV per protocol
D) Administer 50% dextrose IV per protocol
What medication must be held when a patient is getting a procedure with IV contrast? How long must it be held?
Metformin
Must be held 2 days before and after
List "The 7 P's"
Pain, Pallor, Pulselessness, Parathesia, Paralysis, Poikilothermia, Possible line of demarcation
List 3 intervention to prevent DVT.
Early Ambulation
Bed Exercises
Antiembolism Stockings/ Intermittent Compression Devices
Prophylactic Anticoagulation
Which of the following are chronic complications of diabetes? SELECT ALL THAT APPLY.
Diabetic Retinopathy
Nephropathy
Neuropathy
Complications of feet and lower extremities
Infection
What electrolyte must be restored when a patient is in diabetic ketoacidosis?
Potassium
Which of the following should the nurse look out for after administering sulfonylureas? SELECT ALL THAT APPLY.
Hypoglycemia
Persistant cough
GI disturbances
Rash
Photosensitivity
Hypoglycemia
GI disturbances
Rash
Photosensitivity
Your patient has severe peripheral arterial disease. When the lower extremities are elevated you would expect them to appear _______________ and, when they are in the dependent position you would expect them to appear _________________. Fill in the blanks:
A) cyanotic; rubor
B) rubor; pallor
C) cyanotic, pallor
D) pallor; rubor
D) pallor; rubor
What is the antidote for Heparin Sodium?
What is the antidote for Coumadin?
protamine sulfate
Vitamin K