Type 1 DM
Type 2 DM
DM Care
DM Complications
DKA
100

What are common presenting symptoms for a type 1 diabetic? 

3 P's- polyuria, polyphagia, polydipsia

100
The difference between Type 1 and Type 2 diabetics is that type 2 diabetics _________. 

Still produce insulin but have reduced insulin sensitivity or decreased insulin production. 

100

2 Medications/conditions/therapies that may require additional insulin be administered 

Steroids, Phenytoin (Dilantin), TPN, stressful event (surgery)

100

What labs would indicate nephropathy?

Elevated creatinine, albuminurea, elevated BUN


100
These type of fluids are utilized to rehydrate a patient in DKA. Name 1 type of IVF. 

What is hypotonic fluids (drive fluid into cell), .45 NS

200

5 symptoms of a patient with hypoglycemia

Cold, clammy skin, hunger, tachycardic, faintness, dizziness, headache, shakiness. 

200

You are caring for a type 2 DM patient who states they feel lightheaded. They last ate 3 hours ago. What intervention is most appropriate?

Check BG via fingerstick, pt could be hypoglycemic. 

200

Normal fasting glucose level, a 3-month indicator of glucose control, and targeted glucose range

<100, HgbA1C (< 6.5) and 70-110

200

3 education points for the patient with neuropathy

Inspect feet daily, wear flat shoes, no lotion between toes, cut nails straight across, etc. 

200

Name 3 symptoms of a patient in DKA 

Dry mucous membranes, Kussmaul respiration with fruity breath to reverse metabolic acidosis, a glucose level of 250 mg/dL or greater, pH<7.3, bicarb <16, ketonuria 

300
Explain the pathophysiology of Type 1 DM

Autoimmune illness, body attacks beta cells within pancreas resulting in altered function of pancreas--> unable to produce insulin 

300

A Type 2 DM patient is preparing for surgery. What education will be needed? 

Take insulin/oral anti-diabetic agents on the day of surgery if ordered. Maintain NPO status. 

300

Why are mixed drinks not encouraged for a diabetic patient? 

These drinks can contain large amounts of glucose, elevating the patient's glucose with subsequent drops in BG. It is preferred to drink a lighter drink, with food. 

300

What is the best way to prevent diabetes associated complications

Meticulous blood glucose control!

300

What ABG findings would a patient with DKA have? 

Metabolic acidosis, low pH 7.2, low HCo3 <16, generally low CO2 follows as the respiratory system tries to buffer acidosis in the body

400
The Type 1 patient is at home ill with a viral infection. What 3 pieces of nursing education might the clinic nurse provide? 

Check BG every 2-4 hours, consume fluids without added sugar, administer ordered insulin, avoid strenuous exercise, monitor for s/s of DKA 

400

Patient's blood glucose level is 68 and they feel lightheaded. What intervention would you provide? 

Give juice (orange or apple) and recheck glucose in 15 minutes. If not elevated in 15 min, repeat juice and recheck in 15 min. Once elevated, give complex carb (milk/graham cracker) and evaluate cause of hypoglycemia. 

400

 A Type 2 patient comes to the clinic with an A1C reading of 8.4. What lifestyle modification/education is needed? Name 4 items. 

Aerobic exercise 150 min/week, Goal for blood glucose 80-110, Consistent carb diet, low glycemic foods, eat consistent foods, check blood glucose as recommended by MD

400

How might a patient describe neuropathy? What medications would help to treat this condition? 

Tingling, burning, shooting pain, Gabapentin (Neurontin), Pregabalin (Lyrica)

400

What is a priority intervention for a patient in DKA?

IV fluid administration, IV administration of short-acting insulin, Electrolyte replacement, hourly BG checks

500

A diabetic patient has the following presentation: unresponsive to voice or touch, tachycardia, and diaphoresis. What is a priority action?

Check BG and administer 50% dextrose IV per protocol 

500

When might a patient need to check their glucose levels- name 4 incidences 

Prior to administering insulin, prior to meals, if they feel 'low'- hypoglycemic, if they feel 'high'- hyperglycemic, before exercising, before bed 

500

Pt teaching for the type 1 DM to prevent DKA from occurring?

Check BG every 2-4 hours when ill, do not skip insulin doses when ill, check urine for ketones when ill, monitor for 3 P's, Sick day plan from endocrinologist 

500

Name 4 types of complications resulting from uncontrolled diabetes 

Angiopathy, nephropathy, neuropathy, retinopathy, wound healing complications

500

What may be a precipitating cause of DKA

Missing insulin doses, infection, illness, undiagnosed type 1 DM; lack of education, understanding, or resources; and neglect

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