General Questions
Name three Risk Factors of Diabetes Mellitus
- Obesity (esp. abdominal/centrally located)
-Dyslipidemia with high triglycerides and/or low HDL
-Hypertension
Which test is done to diagnose diabetics, what is the range of the test?
Fasting Blood Glucose test >126 mg/dL on at least two occasions
100-125 mg/dL indicates impaired glucose tolerance (IGT/prediabetes)
A nurse teaches a client who is diagnosed with diabetes mellitus. Which statement should the nurse include in this client's 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."
Which type of insulin has ONSET: 15-20 minutes, PEAK: 30-90 mins, DURATION: 5 hours?
Rapid-acting
Short-acting
Intermediate-acting
Long-acting
Rapid-Acting
Type 1 diabetics typically have the following clinical characteristics:*
Thin, young with ketones present in the urine
Diabetes Mellitus Type 1 or Type 2?
1)- a progressive disorder with a combination of insulin resistance and decreased secretion of insulin by pancreatic beta cells.
2) an autoimmune disorder that develops with a precipitating factor of an illness or infection?
1) Diabetes Mellitus Type 2
2) Diabetes Mellitus Type 1
A two hour oral glucose tolerance test of what range would indicate someone is prediabetic and at risk for developing cardiovascular disease?
range for diabetic?
140-199 mg/dL
>200 mg/dL
A nurse assesses a client with diabetes mellitus and notes the client only responds to a sternal rub by moaning, has capillary blood glucose of 33 g/dL, and has an intravenous line that is infiltrated with 0.45% normal saline. Which action should the nurse take first?
a. Administer 1 mg of intramuscular glucagon.
b. Encourage the client to drink orange juice.
c. Insert a new intravenous access line.
d. Administer 25 mL dextrose 50% (D50) IV push.
a. Administer 1 mg of intramuscular glucagon
The client's blood glucose level is dangerously low. The nurse needs to administer glucagon IM immediately to increase the client's blood glucose level. The nurse should insert a new IV after administering the glucagon and can use the new IV site for future doses of D50 if the client's blood glucose level does not rise. Once the client is awake, orange juice may be administered orally along with a form of protein such as a peanut butter.
Which insulins are rapid-acting?
Regular (R)
Humalog (Lispro)
Novalog
NPH
Next
Humalog (Lispro) and Novolog
A nurse assesses a client who has a 15-year history of diabetes and notes decreased tactile sensation in both feet. Which action should the nurse take first?
a. Document the finding in the client's chart.
b. Assess tactile sensation in the client's hands.
c. Examine the client's feet for signs of injury.
d. Notify the health care provider.
c. Examine the client's feet for signs of injury.
Proper way to draw up insulin
Cloudy Clear Clear Cloudy
What range for the Glycosylated Hemoglobin ( Hgb A1C) would indicate poor diabetic control?
> 6.5%
IGT- 5.7-6.4%
An emergency department nurse assesses a client with ketoacidosis. Which clinical manifestation should the nurse correlate with this condition?
a. Increased rate and depth of respiration
b. Extremity tremors followed by seizure activity
c. Oral temperature of 102° F (38.9° C)
d. Severe orthostatic hypotension
a. Increased rate and depth of respiration
Which insulins are intermediate-acting? Lente (L) NPH (N) Regular (R) Humulin Novalog
Lente and NPH
Lente Onset- 3-4 hours peak-6-12 hours duration 16-18 hours
NPH Onset- 2-4 hours Peak- 6-10 hours duration 16-18 hours
After teaching a client who is newly diagnosed with type 2 diabetes mellitus, the nurse assesses the client's 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."
Three common symptoms of Diabetes Mellitus Type 1
Polyuria, Polydipsia, polyphagia
Moderate to high ketones in the urinalysis can indicate?
in the presence of hyperglycemia, can indicate DKA
A nurse assesses a client who has diabetes mellitus. Which arterial blood gas values should the nurse identify as potential ketoacidosis in this client?
a. pH 7.38, HCO3- 22 mEq/L, PCO2 38 mm Hg, PO2 98 mm Hg
b. pH 7.28, HCO3- 18 mEq/L, PCO2 28 mm Hg, PO2 98 mm Hg
c. pH 7.48, HCO3- 28 mEq/L, PCO2 38 mm Hg, PO2 98 mm Hg
d. pH 7.32, HCO3- 22 mEq/L, PCO2 58 mm Hg, PO2 88 mm HgANS: B
When the lungs can no longer offset acidosis, the pH decreases to below normal. A client who has diabetic ketoacidosis would present with arterial blood gas values that show primary metabolic acidosis with decreased bicarbonate levels and a compensatory respiratory alkalosis with decreased carbon dioxide levels.A nurse cares for a client experiencing diabetic ketoacidosis who presents with Kussmaul respirations. Which action should the nurse take?
a. Administration of oxygen via face mask
b. Intravenous administration of 10% glucose
c. Implementation of seizure precautions
d. Administration of intravenous insulin
d. Administration of intravenous insulin
Which insulins are long-acting?
Regular (R)
Ultralente (U)
Novolin
Lantus
Ultralente Onset 4-6 hours Peak 10-16 Duration 18-20hours
Lantus Onset 2-3 hours Peak-almost no peak Duration 18-26 hours
8. A college student who has type 1 diabetes normally walks each evening as part of an exercise regimen. The student now plans to take a swimming class every day at 1:00 PM. The clinic nurse teaches the patient to
a. delay eating the noon meal until after the swimming class.
b. increase the morning dose of neutral protamine Hagedorn (NPH) insulin on days of the swimming class.
c. time the morning insulin injection so that the peak occurs while swimming.
d. check glucose level before, during, and after swimming.
d. check glucose level before, during, and after swimming.
what factors increase and decrease absorption of insulin?
increase- abdomen, increased circulation.warmth, IV route, rapid acting insulin
Slower absorption- buttock, injecting into scar tissue, SQ injection, longer acting insulin
A patient with diabetes has a morning glucose of 50. The patient is sweaty, cold, and clammy. Which of the following nursing interventions is MOST important?
A nurse cares for a client who has diabetes mellitus. The nurse administers 6 units of regular insulin and 10 units of NPH insulin at 0700. At which time should the nurse assess the client for potential problems related to the NPH insulin?
a. 0800
b. 1600
c. 2000
d. 2300
b. 1600
What is the onset, peak, and duration of regular insulin?
a) 15 min, 1 hr, 3 hrs
b) 30-60 mins, 80-120 minutes, 5-7 hrs
c) 30-60 mins, 2-3 hrs, 3-6 hrs
d) 1 hr, 2 hrs, 4-12 hrs
B) 30-60 mins, 80-120 minutes, 5-7 hrs
A diabetic patient has the following presentation: unresponsive to voice or touch, tachycardia, diaphoresis, and pallor. Which of the following actions by the healthcare provider is the priority? Choose 1 answer:Choose 1 answer:
(Choice A)A
Send blood to the laboratory for analysis
(Choice B)B
Administer the prescribed insulin
(Choice C)C
Administer oxygen per nasal cannula
(Choice D)D
Administer 50% dextrose IV per protocol
(Choice D)D
Administer 50% dextrose IV per protocol