Type 1 DM
Type 2 DM
DM Care
DM Complications
DKA
HHS
100

What are common presenting symptoms for a type 1 diabetic? 

3 P's- polyuria, polyphagia, polydipsia

100

The difference between Type 1 and Type 2 diabetics is that type 2 diabetics _________. 

Still produce insulin but have reduced insulin sensitivity or decreased insulin production. 

100

2 Medications/conditions/therapies that may require additional insulin be administered 

Steroids, Phenytoin (Dilantin), TPN, stressful event (surgery)

100

Why would a client have an elevated BG in the morning even after taking evening insulin?

The Somogyi effect: when the insulin causes a decrease in BG and the release of hormones causes a rebound increase to attempt homeostasis


100

These type of fluids are utilized to rehydrate a patient in DKA. Name 1 type of IVF. 

Initially an isotonic solution, then change to hypotonic when BG <300mg/dl (0.45% saline)

100

What is the major difference between DKA and HHS?

Lack of serum/urine ketones

200

5 symptoms of a patient with hypoglycemia

Agitation, 'hangry', tachycardic, diaphoretic, headache, shakiness, fatigue. 

200

You are caring for a type 2 DM patient who states they feel lightheaded. They last ate 3 hours ago. What intervention is most appropriate?

Check BG via fingerstick, pt could be hypoglycemic. 

200

Normal fasting glucose level, 3 month indicator of glucose control, and targeted glucose range

<100, HgbA1C (< 6.5) and 80-110

200

3 education points for the patient with neuropathy

Inspect feet daily, wear flat shoes, do not use heating pads, no lotion between toes, cut nails straight across, etc. 

200

Name 3 symptoms of a patient in DKA 

Confusion, Disorientation, Thirst, Weight loss, tachycardic, hypotensive, Kussmaul's respirations

200

Diagnostic tests for HHS

BG >600, serum osmolality >350, CBC, ABG, BUN, electrolytes

300
Explain the pathophysiology of Type 1 DM

Autoimmune illness, body attacks beta cells within pancreas resulting in altered function of pancreas--> unable to produce insulin 

300

A Type 2 DM patient is preparing for surgery. What education will be needed? 

Do not take insulin/oral anti-diabetic agents the day of surgery. Maintain NPO status. 

300

Name the four ways that a client is screened for Type 2 DM.

(BBOL): BP, BG, Obesity, and Lipids

300

What is the best way to prevent diabetes associated complications

Tight glycemic control

300

What ABG findings would a patient with DKA have? 

Metabolic acidosis, low pH 7.2, low HCo3 <16, generally low CO2 follows as the respiratory system tries to buffer acidosis in the body

300

Name three common causes of HHS

Infection, dialysis, medications (thiazide-diuretics for BP management)

400

The Type 1 patient is at home ill with a viral infection. What 3 pieces of nursing education might the clinic nurse provide? 

Check BG every 2-4 hours, consume fluids without added sugar, administer ordered insulin, avoid strenuous exercise, monitor for s/s of DKA 

400

Patient's blood glucose level is 68 and they feel lightheaded. What intervention would you provide? 

Give juice (orange or apple) and recheck glucose in 15 minutes. If not elevated in 15 min, repeat juice and recheck in 15 min. Once elevated, give complex carb (milk/graham cracker) and evaluate cause of hypoglycemia. 

400

 A Type 2 patient comes to the clinic with an A1C reading of 8.4. What lifestyle modification/education is needed? Name 4 items. 

Aerobic exercise 150 min/week, Goal for blood glucose 80-110, Consistent low carb diet, low glycemic foods, eat consistently, check blood glucose as recommended by MD

400

How might a patient describe neuropathy? What medications would help to treat this condition? 

Tingling, burning, shooting pain, Gabapentin (Neurontin), Pregabalin (Lyrica)

400

What is a priority intervention for a patient in DKA?

Safety, glucose management, hydration with IVF (LR, 0.9% NS , potassium replacement, and hourly BG checks

400

What is the priority intervention for a client with HHS?

Fluid replacement 

500

A diabetic patient has the following presentation: unresponsive to voice or touch, tachycardia, and diaphoresis. What is a priority action?

Check BG and administer 50% dextrose IV per protocol 

500

When might a patient need to check their glucose levels- name 4 incidences 

Prior to administering insulin, prior to meals, if they feel 'low'- hypoglycemic, if they feel 'high'- hyperglycemic, before exercising, before bed 

500

Pt teaching for the type 1 DM to prevent DKA from occurring?

Check BG every 2-4 hours when ill, do not skip insulin doses when ill, check urine for ketones when ill, monitor for 3 P's, Sick day plan from endocrinologist 

500

Name 4 types of complications resulting from uncontrolled diabetes 

 nephropathy, neuropathy, retinopathy, poor wound healing 

500

What may be a precipitating cause of DKA

Missing insulin doses, stress, illness 

500

What is a common complication with the treatment of HHS?

Fluid overload