Diabetes
A nurse explains that type 1 diabetes mellitus is a disease in which the body does not produce enough insulin. What is the reason that the blood glucose is elevated?
Destruction of the beta cells in the pancreas
A young patient complains that diabetes is causing her to “have no life at all. It’s too hard.” What is the most helpful response by the nurse?
“Let’s talk about what makes it so hard.”
A home health care nurse is assessing a patient with type 1 diabetes who has been controlled for 6 months. The nurse is surprised and concerned about a blood glucose reading of 52 mg/dL. What action by this patient most likely caused this episode of hypoglycemia?
A 2-hour long exercise class at the spa this morning
A patient with type 1 diabetes has an insulin order for NPH insulin, 35 U, to be given at 0700. The patient has also been instructed not to take anything by mouth (NPO) in preparation for laboratory work that will not be drawn until 1000. What action should the nurse implement?
Hold the insulin until after the blood draw
How long does it take for Humulin R 20 units to peak?
2 hours
A patient newly diagnosed with type 2 diabetes mellitus asks the nurse why she has to take a pill instead of insulin. The nurse explains that in type 2 diabetes mellitus, the body still makes insulin. What other information is pertinent for the nurse to relay?
The cells become resistant to the action of insulin. Pills are given to increase the sensitivity.
When a patient with type 2 diabetes says, “Why in the world are they looking at my hemoglobin? I thought my problem was with my blood sugar.” What should the nurse explain about the level of hemoglobin A1c?
Shows what the glucose level has done during the past 3 months
As part of a teaching plan in preparation for discharge, a patient with type 1 diabetes needs guidelines for exercise. Which guideline should be included?
Exercise should be performed daily at the same time of day and at the same intensity.
A patient comes to the diabetes clinic and confides to the nurse that she does not follow the diet exchange program that she was given. What is the best response by the nurse?
“Okay. Let’s talk about what you do eat and drink and how you manage your diabetes.”
A nurse suspects that a patient with type 1 diabetes may be experiencing the Somogyi phenomenon. What symptom supports this suspicion?
Headache on awakening and enuresis
A patient tells a nurse that she eats “huge” amounts of food but stays hungry most of the time. What should the nurse explain as the cause of hunger experienced by persons with type 1 diabetes
Fact that the cells cannot use the blood glucose
A patient with type 2 diabetes shows a blood sugar reading of 68 at 6 AM. What action should the nurse implement based on the reading of 72 mg/dL?
Give him 8 oz of skim milk
A patient has come into the emergency department accompanied by a friend who states that the patient had been acting very strangely and seems confused. The friend states that the patient has diabetes and takes insulin. Which signs of hypoglycemia might the nurse assess?
Irritability, anxiety, confusion, and dizziness
A patient with type 1 diabetes asks why his 0700 insulin has been changed from NPH insulin to 70/30 premixed insulin. What is the best explanation by the nurse that explains about 70/30 insulin mixture?
It makes insulin administration easier and safer.
A patient has been admitted with hyperglycemic hyperosmolar nonketotic syndrome (HHNS). The blood glucose level is very high (880 mg/dL) on admission. The physician believes that the condition is the result of large amounts of glucose solutions administered intravenously (IV) during renal dialysis. What should the nurse anticipate that the patient would exhibit?
Severe dehydration and hypernatremia caused by the hyperglycemia
What does the lack of insulin in patients with type 1 diabetes cause that increases the risk for cardiovascular disorders?
Increased fatty acid levels
A nurse assigned to care for a patient with diabetic ketoacidosis (DKA) is aware that this is a life-threatening condition. What will DKA result in?
Disorder of carbohydrates, fats, and proteins metabolism
A patient has come to the physician’s office after finding out that her blood glucose level was 135 mg/dL. She states that she had not eaten before the test and was told to come and see her physician. She asks the nurse if she has diabetes. What is the most accurate nursing response?
“That test indicates that we need to perform more tests that are specific for diabetes.”
What should a nurse include when drawing up a patient’s diabetes teaching plan?
Develop an exercise plan because regular exercise helps control blood glucose levels
What are functional causes of hypoglycemia? (Select all that apply.)
Dumping syndrome
Addison disease
Prolonged muscular exercise
The self-care goal of a patient with diabetes is to keep the blood sugar within normal limits. What causes hyperglycemia to occur?
The body responds to glucose-starved tissues by changing stored glycogen into glucose.
A patient has been admitted to the hospital with the diagnosis of DKA. What vital signs should a nurse anticipate that the patient will exhibit?
Temperature, 97.4 F; pulse, 110 beats/min; respirations, 26 breaths/min and deep
A nurse is formulating a teaching plan for a 22-year-old woman taking rosiglitazone (Avandia). What should the nurse include information about in this plan to caution this patient?
Decreased effectiveness of her birth control pills
What has most likely occurred in a patient who has been diagnosed with endogenous hypoglycemia?
Excessive secretion of insulin or an increase in glucose metabolism
What should a teaching plan about foot care include for a patient with diabetes? (Select all that apply.)
Wash and carefully dry the feet every day
Protect the feet from extreme temperatures
Buy shoes that are comfortable and supportive