Insulin
The client's lunch tray will arrive at 0800, what time should we check the FSBG and what time should we administer the insulin?
Check no more than 15 minutes before the meal
Administer insulin once the food arrives
If the client is not sure what foods are leading to hyperglycemia, what is a nursing intervention that can be done?
Ask the client to create a food diary
The type 2 DM client is usually A/O x 4 but is now confused, lethargic and irritable. What is a priority action?
check the blood glucose level
Who is most at risk for DMT2
Children with genetic or autoimmune predisposition
The client has an Hgb A1C of 6%
What does this mean and what can we do?
Pre-diabetes
Education on modifiable factors
Why would the client be prescribed two different Humalog insulin orders, one sliding and one standing?
What diet are most clients on in the hospital and why?
consistent carbohydrate
consistent intake of carbs helps achieve more stable blood glucose control
The client has a FSBG of 66mg/dL. They deny signs of hypoglycemia but breakfast will not be arriving for 15 minutes. What is the priority action?
Give them a fast acting simple carb/snack
The client with T1DM is playing in a tennis match later today. What should be done prior to and after exercise and what would be reason not to play?
Check FSBG before and after
If FSBG is above 250 and/or ketones in the urine do not exercise/play
The client was just diagnosed with TMD2 this admission. What is the priority for education?
Assess the client's readiness and willingness to learn
Which insulin should be administered with a meal, 5 to 15 minutes prior to a meal, or immediately after the meal?
insulin lispro (Humalog)
Other than carbs, what are some diet guidelines for DM?
low fat
include protein
low simple sugars
The client has a FSBG of 54mg/dL and is lethargic, not opening their eyes but moaning. What is the priority action?
25 to 50 mL of 50% dextrose solution IV
What is unique about type 1 vs type 2
Type 1 has ketones present
Type 1 glucose cannot enter the cells so the body breaks down fat for energy
Name 4 cues related to DM T2 aside from the 3P's
slow to heal wounds
numbness and tingling in the feet
vision changes
dry skin
lethargy
etc.
Which insulin has a 3-6 hour duration and is administertered only once daily
lantus
What fluids should be encouraged with a client who has DMT2?
no soda
no juices
but encourage hydration with water!
The client is sick with the flu and asks how their insulin regimen will change when sick. What are teaching points to include?
Take insulin as prescribed
Take your FSBG every 3-4hours
Increase your fluid intake
Check for ketones in the urine (T1)
Insulin!
The client with T2DM has numbness and tingling in their hands and feet. What are some nursing considerations?
Fall precautions
skin checks
proper FSBG checks
Which insulin is given 30-60 minutes before a meal, onset is 1-2 hours
NPH
Humulin
Novalin
What are some concerning GI cues for DKA?
N/V
weight loss
abdominal pain
The client was treated with IV glucose for hypoglycemia 15 minutes ago. They are now awake and talking and state they feel better overall. What is the priority now?
retake the blood sugar
If not managed properly, what can uncontrolled DM cause?
Vision changes
Impaired kidney function
CAD
Neuropathy
Which antidiabetic medication should the client stop taking 2 days prior to any procedure that involves contrast dye and would warrant monitoring BUN & Creatinine
Metformin