Vision and Hearing
A patient has both hearing and visual sensory impairments. Which psychological nursing diagnosis will the nurse add to the care plan?
A. Risk for falls
B. Self care deficit
C. Social isolation
D. Impaired physical mobility
C. Social isolation
what are the 3 large symptoms of type 1 diabetes?
polyphagia, polydipsia, polyuria
what is the main cause of Cushing's?
overuse of corticosteroids
impaired fasting glucose needs to be over how much to be considered diabetes?
over 125
true or false
you can mix glargine insulin with lispro insulin
false
you cannot mix a long acting insulin (glargine) with ANY insulins
For a hearing-impaired client to hear a conversation, the nurse should:
A. Use a louder tone of voice than normal
B. Use visual aids such as the hands and eyes when speaking
C. Approach a client quietly from behind before speaking
D. Select a public area to have a conversation
B. Use visual aids such as the hands and eyes when speaking
what is the treatment for a hypoglycemic patient?
give 15g of carbs and check q15min until it is normal, then q1 hour and give food/ snack to help maintain.
Glucagon 1mg (<54) SQ injection: when the pt is not able to take oral methods.
S/S of hypothyroidism include:
Cold intolerance, hair loss, dry and scaly skin, brittle nails, husky voice, muscle weakness, weight gain, lethargy, thick tongue, SOB on exertion, low cardiac output, constipation, mental slowing, facial and eyelid edema
what does this lab value mean: Hemoglobin A1C 6.2%
Prediabetes
what important teaching should we give to patients taking metformin?
HOLD this drug 48hrs before and after diagnostic test requiring IV contrast
a patient has AMD, the doctor is prescribing photodynamic therapy, what are the goals of this therapy and the teachings the nurse should give the patient?
Goal is to slow or stabilize vision loss
what is the teaching the nurse should give to a diabetic patient who is wanting to exercise?
Minimum of 150 minutes/week
Eat a carb snack 30 minutes before exercise to prevent hypoglycemia
Check sugar before, during, and after exercise
Do not exercise if blood glucose level > 250 mg/dL and if ketones are present in urine
what should the nurse monitor post op from a thyroidectomy
head and neck support
airway
possible hypocalcemia
discourage talking
the 3 P's, fruity breath, kussmaul respirations, and a BS of 347 would indicate what?
diabetic ketoacidosis
how long after a dose of NPH insulin should a patient wait to eat?
during onset (1-1.5hrs) or peak (4-12hrs)
Which assessment finding alerts the nurse to provide patient teaching about cataract development?
a. History of hyperthyroidism
b. Unequal pupil size and shape
c. Blurred vision and light sensitivity
d. Loss of peripheral vision in both eyes
C. Classic signs of cataracts include blurred vision and light sensitivity. Thyroid problems are a major cause of exophthalmos. Unequal pupil is indicative of anisocoria, not cataracts. Loss of peripheral vision is a sign of glaucoma.
The nurse has taught a patient admitted with diabetes, cellulitis, and osteomyelitis about the principles of foot care. The nurse evaluates that the patient understands the principles of foot care if the patient makes what statement?
a. "I should only walk barefoot in nice dry weather."
b. "I should look at the condition of my feet every day."
c. "I am lucky my shoes fit so nice and tight because they give me firm support."
d. "When I am allowed up out of bed, I should check the shower water with my toes."
b. "I should look at the condition of my feet every day."
Patients with diabetes mellitus need to inspect their feet daily for broken areas that are at risk for infection and delayed wound healing. Properly fitted (not tight) shoes should be worn at all times. Water temperature should be tested with the hands first.
a patient comes to the ER with a fever of 102, HR of 146, confusion, BP 172/84, the nurse knows the treatment for this is:
Beta blockers (“lol”, help with symptom control)
PTU (propylthiouracil)
Antipyretics (to reduce fever)
Cooling measures (hypothermia blankets, ice packs in places that will cool body down fastest)
Methimazole (blocks synthesis of thyroid hormone)
IV fluids, oxygen
what do these lab values indicate?
TSH: 4.7, T3:76, T4: 5.2
hypothyroidism
what important teaching will the nurse give to a patient who is prescribed methimazole?
name the nursing considerations for a patient with hearing loss:
Use a low tone, face patient when speaking, speak slowly, reduce noise, write out information, allow time for patient to process information
The nurse is teaching a 60-year-old woman with type 2 diabetes mellitus how to prevent diabetic nephropathy. Which statement made by the patient indicates that teaching has been successful?
a. "Smokeless tobacco products decrease the risk of kidney damage."
b. "I can help control my blood pressure by avoiding foods high in salt."
c. "I should have yearly dilated eye examinations by an ophthalmologist."
d. "I will avoid hypoglycemia by keeping my blood sugar above 180 mg/dL."
b. "I can help control my blood pressure by avoiding foods high in salt."
Diabetic nephropathy is a microvascular complication associated with damage to the small blood vessels that supply the glomeruli of the kidney. Risk factors for the development of diabetic nephropathy include hypertension, genetic predisposition, smoking, and chronic hyperglycemia. Patients with diabetes are screened for nephropathy annually with a measurement of the albumin-to-creatinine ratio in urine; a serum creatinine is also needed
patient comes to the ER with decreased LOC, lethargy, decreased rr, hypothermia, BS of 57, Na 132, BP 86/57, HR 48, based on these S/S, the nurse anticipates what interventions needing to be performed?
treatment for myxedema:
IV thyroid replacement (T4 and T3 administered), mechanical ventilation, cardiac monitoring, monitor body temperature (warming), VS, WT, I&O
what diagnostics do we use for diabetes?
A1C over 6.5
Fasting glucose over 125.
Classic signs and symptoms with random plasma glucose over 200 mg/dL or higher
PAIRED WITH: talking to patient/ history
what is the important teaching for levothyroxine and what does it treat?
hypothyroidism, teach patient that it is a lifelong replacement, take on an empty stomach (at least 30 minutes before breakfast), interacts with lots of other drugs