Diabetes A
What is the number one complication of diabetes?
cardiovascular disease
A newly diagnosed diabetic patient asks the nurse why he needs to check his feet every day. How should the nurse respond?
To check for any cuts, sores, or dry cracked skin so they can be treated early to prevent infection or gangrene.
ICF makes up _______ of total water body.
2/3rds or 70%
In the PACU, the postoperative client suddenly becomes cyanotic. What should the nurse do FIRST?
Reposition the head and determine patency of airway
Explanation:
It is important to determine if the airway is patent and whether the client is breathing. If there is a lot of mucus and gurgling in the upper airway, the client should be suctioned. The airway must be assessed before determining a course of action.
How often should a diabetic patient get screened for peripheral neuropathy and retinopathy ?
Annually
A patient with severe hypoglycemia arrives at the ED unconscious by ambulance. What should the nurse do first?
Give 1 mg of glucagon
What is a simple and accurate method of determining water balance?
Weighing the patient under exact condition -same time, same clothing, same equipment
Which chemical is the most abundant in ECF. Also Maintains water balance, osmolality, transmitting nerve impulses, and contracting muscles, and Regulated by salt intake, aldosterone?
Sodium (NA+)
A client is scheduled for surgery in the morning. Preoperative orders have been written. What is most important to do before surgery?
Verify informed consent has been signed/obtained
What should the nurse educate a diabetic patient about when they are sick?
May need to test blood glucose more often
Do not eliminate meds
stay in contact with HCP, especially if vomiting
DRINK FLUIDS and REST
The nurse enters a diabetic patient's room at 11:30 and notices that the patient is diaphoretic, tachycardic, anxious, states she is hungry, and doesn't remember where she is. This patient is most likely showing signs of what?
Hypoglycemia
Severe s/s of hypoglycemia are dependent on what three things?
The rate of fall
usual blood glucose range
clients ability to recognize drop in blood sugar
Name 3 functions of water
Provides extracellular transportation route to deliver nutrients to the cells and carry waste products from the cell
Provides a medium for chemical reaction or metabolism
Acts as a lubricant for tissues
Maintain acid-base balance
Assist in heat regulation by evaporation
what is experienced by a patient who is under general anesthesia?
The patient is unconscious
Whats does Glycated Hemoglobin (A1C)- blood test reflect?
the average glucose level for 2-3 month period - useful for monitoring but also used at dx.
What are the microvascular complications of uncontrolled diabetes?
Delayed gastric emptying
Glomuerular injury
Bleeding of retinal capillaries
Impotence
List the causes of hypoglycemia
Too much insulin or oral medication
Too little food
excessive physical activity
Not testing or monitoring
ECF is composed of what three fluids?
Intravascular --> plasma w/in vessel
Interstitial --> surrounds cell
Transcelular --> CSF, sweat, synovial fluid
What members are not part of the sterile surgical team?
Hint (2) members
Circulating nurse and the anesthesiologist
Explanation:
The surgeon, rad tech, and scrub nurse directly come in contact with the sterile field. They comprise the sterile surgical team
Insulin resistance and impaired beta cell function results in what?
decreased insulin production
A urine test in an undiagnosed diabetic patient may show.....
Glucose and Ketones in the urine
What are the 5 complications of insulin therapy?
Lipohypertrophy= skin changes r/t using same injection site repeatedly
Insulin Resistance= usually caused by obesity
Dawn phenomenon= normal glucose until about 3 am - may require extra insulin in the am
Somogyi effect= nocturnal hypoglycemia followed by am hyperglycemia
Insulin waning = increase blood glucose from bedtime to morning
What electrolyte, found in ICF is crucial for cardiac, skeletal, and sooth muscle?
Potassium
A nurse is explaining the concept of time-out in the perioperative area. The purpose of time out is:
To allow the surgical team a chance to verbally verify their agreement about the client's name, surgical procedure, and the site.
The time-out occurs in the perioperative area after the client has been prepped and draped. The entire team must verbally verify their agreement regarding the client's name, the procedure to be performed, and the surgical site.
Name the causes of hyperglycemia
Insulin- not enough of it
Food- high in glycemic index
Exercise- not enough
Infection- always causes increase in gucose
Stress
Lack of testing/monitoring- bases control on how one feels