Prioritization
A patient with T1DM is NPO for surgery; the nurse must take this action regarding their basal insulin.
What is "Administer as prescribed (or consult) to prevent DKA, but do not hold entirely"?
This is the very first action a nurse should take when a patient with Type 1 Diabetes presents with shakiness, diaphoresis, and irritability
What is administering 15g of rapid-acting carbohydrates?
The specific class of oral agents that carries a high risk of a "disulfiram-like" reaction with alcohol.
What are Sulfonylureas?
The life-threatening condition characterized by profound dehydration but an absence of ketosis.
What is HHNS (Hyperosmolar Hyperglycemic Nonketotic Syndrome)?
The reason why a nurse would instruct a patient not to inject insulin into their thigh before a jog.
What is "Exercise increases absorption at the injection site, causing rapid hypoglycemia"?
After administering Glucagon IM, this is the nurse's immediate priority to prevent aspiration.
What is turning the patient onto their side (Side-lying position)
When a patient is unconscious due to severe hypoglycemia and cannot swallow, the nurse must prepare to administer this medication via intramuscular injection.
What is Glucagon?
This medication class (e.g., Acarbose) must be held if the patient does not have an active food tray.
What are Alpha-Glucosidase Inhibitors?
The nerve-related condition that causes delayed gastric emptying and frequent nausea/vomiting.
What is Gastroparesis?
The priority diagnostic test for a patient with a glucose of 280 mg/dL who is ill/stressed.
What is Urine Ketone Testing?
a blood glucose of 50 mg/dL. They are conscious but "sleepy." This is the first intervention.
What is 15g of simple carbohydrates (e.g., 4oz juice)?
During the "Stress of Illness," the nurse should instruct the patient to increase their intake of this specific type of fluid to prevent dehydration.
What are non-caloric fluids?
This insulin type has a peak action of "none"—providing a 24-hour steady state.
What is Glargine (Lantus)?
The leading cause of end-stage renal disease (ESRD) in diabetic patients.
What is Diabetic Nephropathy?
The timeframe (in weeks) when all pregnant women should be screened for Gestational DM.
What is 24 to 28 weeks?
A nurse finds a T1DM patient with fruit-scented breath and rapid breathing. This is the first IV fluid priority.
What is Isotonic saline (0.9% NaCl) for rehydration?
This is the priority nursing intervention for a patient in Hyperosmolar Hyperglycemic Nonketotic Syndrome (HHNS) to address severe dehydration.
What is administration of Isotonic IV fluids (0.9% NaCl)?
The organ function that must be strictly monitored in patients taking Thiazolidinediones (TZDs).
What is Liver function?
The physiological reason why chronic hyperglycemia causes Retinopathy and Nephropathy.
What is Microvascular damage/basement membrane thickening?
The "Rule" used for treating hypoglycemia and the amount of carbs used in each step.
What is the Rule of 15 (15g carbs, wait 15 mins)?
You have four patients: One with a glucose of 250, one with a "cold and clammy" sweat, one needing discharge teaching, and one with an A1C of 9%. Who do you see first?
Who is the "Cold and Clammy" patient? (Hypoglycemia is an immediate brain-safety priority).
The nurse teaches the patient that if a hypoglycemic episode occurs, they should consume 15g of rapid-acting carbs and then do this if the patient has responded and a meal is not for another hour.
What is "feed a carbohydrate and protein source" (or a snack)?
These oral medications (e.g., Glyburide) work by directly stimulating the pancreas to "squeeze" out insulin.
What are Sulfonylureas?
A patient with autonomic neuropathy is at high risk for this "silent" cardiac event.
What is a Silent Myocardial Infarction (Heart Attack)?
The statistical likelihood (%) that a woman with Gestational DM will develop Type 2 DM within 20 years.
What is 35% to 60%?