#6: indigenous health Flashcards
2 preventions of diabetes
- Address the underlying social and physical challenges (i.e,, geographic constraints to
affordable, health food, mental health, diabetes prevention programs and activities - Empower individuals to make healthy life choices
2 interventions for diabetes
-must be culturally appropriate and tailored to meet the specific needs of communities
- Adequate and secure funding and resources are needed over a long period to ensure dedicated full time staff can be employed to implement programs
3 aspects of effective diabetes prevention
- dependent on the quality of health information and
education programs. - ease and accessibility of the information, the
relevancy and the ways in which the information is
conveyed - tailored to meet the needs of individuals and
communities, including linguistic and cultural
differences, varying levels of health literacy, and
preferred way of learning
priority action to DKA when pt is lethargic
- check pt infusion
The nurse is caring for a client admitted with type 2 diabetes who asks the nurse what “type 2” means. Which of the following statements is the best response by the nurse?
A. “With type 2 diabetes, the body of the pancreas becomes inflamed.”
B. “With type 2 diabetes, insulin secretion is decreased and insulin resistance is increased.”
C. “With type 2 diabetes, the client is totally dependent on an outside source of insulin.”
D. “With type 2 diabetes, the body produces autoantibodies that destroy B-cells in the pancreas.”
B. “With type 2 diabetes, insulin secretion is decreased and insulin resistance is increased.”
(In type 2 diabetes mellitus, the secretion of insulin by the pancreas is reduced and the cells of the body become resistant to insulin or both.)
The nurse is caring for a 54–year–old client who is hospitalized with diabetes mellitus. Which of the following laboratory test results would provide information related to the client’s past glucose control?
A. Prealbumin level
B. Urine ketone level
C. Fasting glucose level
D. Glycosylated hemoglobin level
D. Glycosylated hemoglobin level
(A glycosylated hemoglobin level (or hemoglobin A1C [A1C] test) detects the amount of glucose that is bound to red blood cells (RBCs). When circulating glucose levels are high, glucose attaches to the RBCs and remains there for the life of the blood cell, which is approximately 120 days. Thus the test can give an indication of glycemic control over approximately 2–3 months.)
The nurse is teaching a client with diabetes mellitus how to perform self-monitoring of blood glucose (SMBG). Which of the following actions by the client should alert the nurse that additional teaching is required?
A. Chooses a puncture site in the centre of the finger pad
B. Washes hands with soap and water to cleanse the site to be used
C. Warms the finger before puncturing the finger to obtain a drop of blood
D. Tells the nurse that the result of 6.66 mmol/L indicates good control of diabetes
A. Chooses a puncture site in the centre of the finger pad
(The client should select a site on the sides of the fingertips, not on the centre of the finger pad. This area contains many nerve endings and would be unnecessarily painful.)
The nurse is teaching a client with diabetes about proper composition of the daily diet. Which of the following percentages should the nurse explain is the guideline for daily carbohydrate intake?
A. 80%
B. 30%
C. 45%
D. 25%
C. 45%
(The recommendation for carbohydrate intake is 45% to 60% of daily energy. Low-carbohydrate diets are not recommended for diabetes management.)
The nurse is caring for a client diagnosed with type 2 diabetes. In formulating a teaching plan that encourages the client to actively participate in management of the diabetes, which of the following actions should the nurse do first?
A. Assess client’s perception of what it means to have diabetes.
B. Ask the client to write down current knowledge about diabetes.
C. Set goals for the client to actively participate in managing his diabetes.
D. Assume responsibility for all of the client’s care to decrease stress level.
A. Assess client’s perception of what it means to have diabetes.
(In order for teaching to be effective, the first step is to assess the client. Teaching can be individualized once the nurse is aware of what a diagnosis of diabetes means to the client.)
The nurse is beginning to teach a diabetic client about vascular complications of diabetes. Which of the following information would be appropriate for the nurse to include in the teaching plan?
A. Macroangiopathy does not occur in type 1 diabetes but rather in type 2 diabetics who have severe disease.
B. Microangiopathy is specific to diabetes and most commonly affects the capillary membranes of the eyes, kidneys, nerves, and skin.
C. Renal damage resulting from changes in large- and medium-sized blood vessels can be prevented by careful glucose control.
D.Macroangiopathy causes slowed gastric emptying and the sexual impotency experienced by a majority of clients with diabetes.
B. Microangiopathy is specific to diabetes and most commonly affects the capillary membranes of the eyes, kidneys, nerves, and skin.
(Microangiopathy occurs in diabetes mellitus. The areas of the body most noticeably affected are the eyes (retinopathy), the kidneys (nephropathy), the nerves (neuropathy), and the skin (dermopathy). Sexual impotency and slowed gastric emptying result from microangiopathy. Macroangiopathy can occur in either type 1 or type 2 diabetes.)
The nurse is evaluating a client diagnosed with type 1 diabetes mellitus. Which of the following symptoms reported by the client is considered one of the classic clinical manifestations of diabetes?
A. Excessive thirst
B. Gradual weight gain
C. Overwhelming fatigue
D. Recurrent blurred vision
A. Excessive thirst
(The classic symptoms of diabetes are polydipsia (excessive thirst), polyuria, (excessive urine output), and polyphagia (increased hunger).)
The nurse is caring for a client with diabetes mellitus who is scheduled for a fasting blood glucose level at 0800 hours the next day. The nurse instructs the client to only drink water after which of the following times?
A. 1800 hours
B. 0400 hours
C. Midnight
D. 0700 hours
C. Midnight
Typically, a client is ordered to be NPO for eight hours before a fasting blood glucose level. For this reason, the client who has a laboratory draw at 0800 hours should not have any food or beverages containing any calories after midnight.
The nurse is caring for a client with diabetes mellitus who has a glucose level of 21.1 mmol/L and a moderate level of ketones in the urine. As the nurse assesses for signs of ketoacidosis, which of the following respiratory patterns would the nurse expect to find?
A. Central apnea
B. Hypoventilation
C. Kussmaul’s respirations
D. Cheyne-Stokes respirations
C. Kussmaul’s respirations
In diabetic ketoacidosis, the lungs try to compensate for the acidosis by blowing off volatile acids and carbon dioxide. This leads to a pattern of Kussmaul’s respirations, which are deep and nonlaboured.
The nurse is assisting a diabetic client to learn dietary planning as part of initial management of diabetes. The nurse would encourage the client to limit intake of which of the following foods to help reduce the percent of fat in the diet?
A. Cheese
B. Broccoli
C. Chicken
D. Oranges
A. Cheese
Cheese is a product derived from animal sources and is higher in fat and calories than vegetables, fruit, and poultry.
The nurse is reviewing laboratory results for a client with a 15-year history of diabetes. Which of the following laboratory results follows the expected pattern accompanying macrovascular disease as a complication of diabetes?
A. Increased triglyceride levels
B.Decreased low-density lipoproteins
C. Increased high-density lipoproteins
D. Decreased very-low-density lipoproteins
A. Increased triglyceride levels
Macrovascular complications of diabetes include changes to large- and medium-sized blood vessels. They include cerebro-vascular, cardiovascular, and peripheral vascular disease. Increased triglyceride levels are associated with these macrovascular changes. For this reason, the client should limit the amount of fat in the diet.
