Nursing process
What is the initial nursing intervention for a conscious patient with nervousness, tremors, and tachycardia?
What is check blood glucose?
(Adapted from Table 53.21 data from Lewis et al., 2022)
This type of deep, labored breathing pattern is a classic sign of diabetic ketoacidosis (DKA).
What are Kussmaul respirations?
(Adapted from Table 53.13 data from Lewis et al., 2022)
The nurse will instruct a type 2 diabetic to hold this oral diabetic medication 1-2 days before IV contrast media is given and for 48 hours after.
What is Metformin?
(Adapted from Table 53.8 data from Lewis et al., 2022)
This rapid-acting insulin is inhaled.
What is Afrezza?
(Adapted from Table 53.4 data from Lewis et al., 2022)
What is the appropriate nursing intervention for a patient whose glucose is still <70 mg/dL after drinking 6 oz of orange juice 15 minutes ago?
What is have the patient drink another 15-20 g of carbohydrate?
(Adapted from Table 53.21 data from Lewis et al., 2022)
Hyperglycemia, ketosis, acidosis, and dehydration are characteristics of this life-threatening condition.
What is diabetic ketoacidosis (DKA)?
(Lewis et al., 2022, p. 1308)
This is how long insulin vials and pens in use may be safely kept at room temperature before being discarded.
What is 4 weeks?
(Lewis et al., 2022, p. 1293)
This is the term for the continuous 24-hour infusion of rapid-acting insulin delivered by an insulin pump.
What is the basal rate?
(Lewis et al., 2022, p. 1294)
This test is used to assess sensory function in the feet and lower extremities annually.
What is a monofilament test?
Changes in subcutaneous fatty tissue characterize this condition.
What is Lipodystrophy?
(Lewis et al., 2022, p. 1295)
What is glucagon?
(Adapted from Table 53.21 data from Lewis et al., 2022)
This type of insulin has an onset of 10-30 minutes, a peak action of 30 minutes to 3 hours, and a duration of 3-5 hours.
What is short-acting/regular insulin; Humulin R; Novolin R
(Adapted from Fig. 53.4 data from Lewis et al., 2022)
Nurses will plan to administer this medication for severe acidosis (pH < 7.0).
What is sodium bicarbonate?
(Adapted from Table 53.20 data from Lewis et al., 2022)
This diagnostic finding, often present in diabetic ketoacidosis, indicates the body is breaking down fat for energy.
What is ketonuria?
(Lewis et al., 2022, p. 1309)
Patients taking this oral diabetes medication should be instructed to take it with the first bite of each main meal.
What is acarbose; miglitol; or alpha-glucosidase inhibitors?
(Adapted from Table 53.8 data from Lewis et al., 2022)
These are two common side effects when taking Meglitinides or Sulfonylureas.
What is weight gain and hypoglycemia?
(Adapted from Table 53.8 data from Lewis et al., 2022)
A patient with diabetes has a serum glucose level of 824 mg/dL (45.7 mmol/L) and is unresponsive. After assessing the patient, the nurse suspects diabetes-related ketoacidosis rather than hyperosmolar hyperglycemia syndrome based on the finding of
a. Polyuria.
b. severe dehydration.
c. rapid, deep respirations.
d. decreased serum potassium.
Correct answer: c
Rationale: Signs and symptoms of DKA include manifestations of dehydration, such as poor skin turgor, dry mucous membranes, tachycardia, and orthostatic hypotension. Early symptoms may include lethargy and weakness. As the patient becomes severely dehydrated, the skin becomes dry and loose, and the eyeballs become soft and sunken. Abdominal pain is another symptom of DKA that may be accompanied by anorexia and vomiting. Kussmaul respirations (i.e., rapid, deep breathing associated with dyspnea) are the body’s attempt to reverse metabolic acidosis through the exhalation of excess carbon dioxide. Acetone is identified on the breath as a sweet, fruity odor. Laboratory findings include a blood glucose level greater than 250 mg/dL, arterial blood pH less than 7.30, serum bicarbonate level less than 15 mEq/L, and moderate to high ketone levels in the urine or blood.
(Lewis et al., 2022, p. 1320)