Diabetes Management
A nurse is caring for a client who has a blood glucose of 52 mg/dL. The client is lethargic but arousable. Which of the following actions should the nurse perform first?
A. Recheck blood glucose in 15min.
B. Provide a Carbohydrate and protein food.
C. Provide 4oz. of grape juice
D. Report findings to the provider
C. Provide 4 oz of grape juice
A nurse is assessing client who has DKA and ketones in the urine. Which of the following are expected findings? (Select all that apply)
A. Weight gain
B. Fruity odor of breath
C. Abdominal pain
D. Kussmaul respirations
E. Metabolic acidosis
B. Fruity odor of breath
C. Abdominal pain
D. Kussmaul respirations
E. Metabolic acidosis
A nurse teaches a client who is diagnosed with diabetes mellitus. Which statement should the nurse include in this clients plan of care to delay the onset of microvascular and macrovascular complications?
A. Maintain tight glycemic control and prevent hyperglycemia.
B. Restrict your fluid intake to no more than 2 liters a day.
C. Prevent hypoglycemia by eating a bedtime snack.
D. Limit your intake of protein to prevent ketoacidosis.
A. Maintain tight glycemic control and prevent hyperglycemia.
Hyperglycemia is a critical factor in the pathogenesis of long-term diabetic complications. Maintaining tight glycemic control will help delay the onset of complications. Restricting fluid intake is not part of the treatment plan for clients with diabetes. Preventing hypoglycemia and ketosis, although important, are not as important as maintaining daily glycemic control.
A nurse is preparing to administer a morning dose of Aspart Insulin (NovoLog) to a client who has type 1 diabetes mellitus. Which of the following is an appropriate action by the nurse?
A. Check Blood Glucose Immediately After Breakfast
B. Administer Insulin When Breaksfast Arrives
C. Hold Insulin for 1hour after insulin administration
D. Clarify the prescription because insulin should not be administered at this time
B. Administer the insulin when breakfast arrives
A nurse is reviewing lab reports of a client who is in a hyperglycemic-hyperosmolar state (HHS). Which of the following is an expected finding?
A. Serum pH 7.2
B. serum osmolarity 350 mOsm/L
C. Serum potassium 3.8mg/dL
D. serum creatinine 0.8mg/dL
B. Serum Osmolarity of 350 mOsm/L
After teaching a client who is newly diagnosed with type 2 diabetes mellitus, the nurse assesses the clients understanding. Which statement made by the client indicates a need for additional teaching?
A. I should increase my intake of vegetables with higher amounts of dietary fiber.
B. My intake of saturated fats should be no more than 10% of my total calorie intake.
C. I should decrease my intake of protein and eliminate carbohydrates from my diet.
D. My intake of water is not restricted by my treatment plan or medication regimen.
C. I should decrease my intake of protein and eliminate carbohydrates from my diet.
The client should not completely eliminate carbohydrates from the diet, and should reduce protein if microalbuminuria is present. The client should increase dietary intake of complex carbohydrates, including vegetables, and decrease intake of fat. Water does not need to be restricted unless kidney failure is present.
A nurse is preparing to administer the morning dose of Glargine (Lantus) insulin and regular (Humulin R) insulin to a client who has a blood glucose of 278 mg/dL. Which of the following is an appropriate nursing action?
A. Draw up the regular insulin and then the glargine insulin in the same syringe.
B. Draw up the glargine insulin and then the regular insulin in the same syringe.
C. Draw up and administer regular and glargine insulin in separate syringes.
D. Administer the regular insulin, wait 1 hour, and then administer the glargine insulin.
C. Draw up and administer regular and glargine insulin in separate syringes.
Oh no, your patient just had a family member sneak her in two pieces of cake!
Her blood glucose level went up 30 points! :(
A nurse is preparing to administer IV fluids to a client who has Diabetic Ketoacidosis. Which of the following is an appropriate nursing action?
A. Administer an IV infusion of regular insulin at 0.3units/kg/hr
B. Administer an IV infusion of 0.45% sodium chloride
C. Rapidly administer an IV infusion of 0.9% sodium chloride
D. Add glucose to the IV when serum glucose is at 350mg/dL
C. Rapidly administer an IV infusion of 0.9% sodium chloride
A nurse is presenting information to a group of clients about nutrition habits that prevent type 2 diabetes mellitus. Which of the following should the the nurse include in the information? (Select all that apply)
A. Eat less meat and processed foods
B. Decrease intake of saturated fats
C. Increase daily fiber intake
D. Limit Saturated Fat intake to 15% of daily caloric intake
E. Include omega-3 fatty acids in the diet
A. Eat less meat and processed foods
B. Decrease intake of saturated fats
C. Increase daily fiber intake
E. Include omega-3 fatty acids in the diet
A nurse is providing discharge teaching to a client who experienced diabetic ketoacidosis. Which of the following should the nurse include in the teaching? (select all that apply)
A. Drink 3 L of fluid daily
B. Monitor blood glucose every 4 hours when ill
C. Administer insulin as prescribed when ill.
D. Notify the provider when blood glucose is 200mg/dL
E. Report ketones in the urine after 24 hours of illness
A. Drink 3 L of fluid daily
B. Monitor glucose every 4 hours when ill
C. Administer insulin as prescribed when ill
E. Report ketones in the urine after 24 hours of illness
A nurse assesses clients at a health fair. Which clients should the nurse counsel to be tested for diabetes? (Select all that apply.)
A. 56-year-old African-American male
B. Female with a 30-pound weight gain during pregnancy
C. Male with a history of pancreatic trauma
D. 48-year-old woman with a sedentary lifestyle
E. Male with a body mass index greater than 25 kg/m2
F. 28-year-old female who gave birth to a baby weighing 9.2 pounds.
A. 56-year-old African-American male
D. 48-year-old woman with a sedentary lifestyle
E. Male with a body mass index greater than 25 kg/m2
F. 28-year-old female who gave birth to a baby weighing 9.2 pounds.
Risk factors for type 2 diabetes include certain ethnic/racial groups (African Americans, American Indians, Hispanics), obesity and physical inactivity, and giving birth to large babies. Pancreatic trauma and a 30-pound gestational weight gain are not risk factors.
A nurse is teaching foot care to a client who has diabetes mellitus. Which of the following information should the nurse include in the teaching? (Select all that apply)
A. Remove calluses using OTC remedies
B. Apply lotion between toes
C. Perform nail care after bathing
D. Trim toenails straight across
E. Wear closed-toe shoes
C. Perform nail care after bathing
D. Trim toenails straight across
E. Wear closed-toe shoes
A nurse is reviewing the health record for a client who has hyperglycemic-hyperosmolar state (HHS). Which of the following data relates to this diagnosis? (Select all that apply)
A. Evidence of recent MI
B. BUN 35 mg/dL
C. Takes a calcium channel blocker
D. Age 77
E. No insulin production
A. Evidence of recent MI
B. Bun 35 mg/dL
C. Takes calcium channel blocker
D. Age 77
Your patient received two units of insulin!
Their blood glucose level went down 50 points!