Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

ch 37 diabetes > ch 37 questions and topics > Flashcards

ch 37 questions and topics Flashcards

1
Q

the nurse identifies a need for additional teaching when the patient who is self monitoring blood glucose levels…

A

chooses a puncture site in the center of the finger pad

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

a type 2 diabetic is ordered metformin (glucophage) as part of the management regimen. which is the best nursing explanation for the action of this drug in controlling glucose levels?

A

helps tissues use insulin more efficiently

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

a diabetic client maintains glucose control with the use of long acting and short acting insulin. which nursing instruction would be considered a priority teaching issue with this client?

A

if using Lantus or Levemir give in separate syringes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

which is the primary reason for encouraging injection site rotation in an insulin dependent diabetic?

A

to promote absorption and prevent lipohypertrophy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

a client with untreated type 1 diabetes mellitus may lapse into a coma because of acidosis. Which component in the blood is a direct cause of this type of acidosis?

A

ketones

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

a 27 y/o patient admitted with diabetic ketoacidosis has a serum glucose level of 732 and a serum potassium level of 3.1. Which action prescribed by the healthcare provider should the nurse take first?

A

place the patient on a cardiac monitor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

an unresponsive patient with type 2 diabetes is brought to the emergency department and diagnosed with hyperosmolar hyperglycemic syndrome (HHS). the nurse will anticipate the need to?

A

insert an IV catheter

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

which is the best nursing explanation for the symptom of polyuria in the client with diabetes mellitus?

A

high sugar pulls fluid into the bloodstream, which results in more urine production

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

different types of diabetes (4)

A
  • type 1: insulin dependent; little or no insulin is produced. can develop KETOACIDOSIS. controlled with insulin
  • type 2: insulin resistant; body can not efficiently use the insulin it produces. can develop HHS. controlled mainly with oral drugs and lifestyle but also can be controlled with insulin.
  • LADA (latent autoimmune diabetes in adults): slow onset of type 1 diabetes; eventually islet antibodies destroy the beta cells. often misdiagnosed as type 2 diabetes. dx criteria onset after age 30, islet antibodies present in the blood, insulin is not required sooner than 6 months after dx. Rapid failure of ORAL diabetic drugs indicates LADA
  • gestational: occurs only with pregnancy; after pregnancy there is a 35-60% chance of developing diabetes within 5-10 years
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what is most important when caring for a patient with ketoacidosis?

A
  • treating hypovolemia and maintaining tissue perfusion
  • giving insulin, IV fluid, correcting electrolyte imbalances
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what type of medication, specifically insulin, would you give for a diabetic ketoacidosis patient?

A

IV regular insulin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what is the best nursing interpretation of a patient that is taking oral medication for control of sugar problems? what are they trying to control?

A

type 2 diabetes mellitus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

a patient who has type 2 diabetes is being prepared for an elective coronary angiogram. which information would the nurse anticipate might lead to rescheduling the test?

A

the patient took their prescribed metformin today

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

a patient who was admitted with diabetic ketoacidosis secondary to a UTI has been weaned off an insulin drip 30 minutes ago. the patient reports feeling lightheaded and sweaty. which action should the nurse take first?

A

obtain a glucose reading using a finger stick

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

to monitor for complications in a patient with type 2 diabetes, which tests will the nurse in the diabetic clinic schedule at least annually?

A
  • blood pressure
  • serum creatinine
  • urine for microalbuminuria
  • monofilament testing of the foot
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

a female patient is scheduled for an oral glucose tolerance test. which information from the patient’s health history is most important for the nurse to communicate to the healthcare provider?

A

patient uses oral contraceptives
- can alter the results of the test

17
Q

the nurse is providing information about foot care to a patient with diabetes. which of the following would the nurse include?

A

“be sure to apply a moisturizer to feet daily.”

-the patient should also inspect their feet at least once a day using a mirror or having someone else check

18
Q

what could cause blood sugar to elevate?

A

stress, diet choices, improper insulin/oral medication administration

19
Q

factors that influence the development of diabetes (4)

A
  • genetic
  • metabolic
  • microbiological
  • immunologic
20
Q

what is glycosylated hemoglobin?

A

reflects the amount of glucose stored in hemoglobin over past several months
(usually 3 months, also called an HbA1c)

21
Q

proper levels for A1c
(as stated in the textbook)

A
  • lowering level to 6.5% decreases risks for kidney, eye, and nerve diseases
  • if patient is very old, frail, or the life expectancy is short, less than 8-8.5%
22
Q

an elderly patient needs to draw up insulin, what do you need to help them verify that they are drawing up the correct dosage?

A

a syringe magnifier

23
Q

Hemoglobin A1c measures what?

A

that blood glucose has stayed within normal limits from one testing period to the next

24
Q

if a diabetic patient has an injury to the foot that they are unaware of, how is that explained to the patient?

A

high blood sugar levels decreases blood circulation to nerves
neuropathy can be painful and also decrease sensation to extremities, especially the feet

25
Q

metformin (glucophage)

A

*only med in biguanides class
[keeps the liver from releasing excessive insulin, makes muscle cells more sensitive to insulin]

26
Q

basal and bolus (correction dose) insulins

A
  • basal insulin: the amount of insulin that would normally be produced by the pancreas throughout the day to maintain blood sugar between meals
    ~ a basal dose can be used in an insulin pump to deliver continuously to help maintain throughout the day
  • bolus/correction dose: short or rapid acting insulin is used to manage elevations in blood glucose and bring the next measurement into range
    ~ a bolus dose can also be programmed into the pump to deliver prior to meals or elevated sugar levels

CGM: continuous glucose monitoring

27
Q

SHORT ACTING INSULIN also known as regular insulin

A
  • Humulin R, Novolin R

~onset: 30 minutes
~PEAK: 2-4 hours
~duration: 5-7 hours

28
Q

INTERMEDIATE ACTING INSULIN also known as NPH

A
  • Humulin N, Novolin N, ReliOn N

~onset: 1.5 hours
~PEAK: 4-12 hours
~duration: 16-24 hours

29
Q

LONG ACTING INSULIN also known as Glargine or Detemir

A
  • Lantus
  • Levemir

~onset: 2-4 hours
~PEAK: NO PEAK
~duration: 24 hours +

30
Q

RAPID ACTING INSULIN also known as insulin aspart, lispro, or glulisine

A
  • NovoLog, HumaLog, Apidra

~onset: 15 minutes
~PEAK: 1-3 hours
~duration: 3-5 hours

31
Q

incretin mimetics

A

mimic the action of incretins, hormones released from the intestine

32
Q 
diabetic ketoacidosis
A
  • when insulin is not present in adequate amounts to meet metabolic needs, the body breaks down protein & fat for energy
    ~ this produces KETONES which are a by product of fat metabolism

~ the body will try to rid itself of metabolic acidosis by doing the following:
- increased resp rate and depth Kussmaul Respirations
- acetone (ketone body) excreted in urine called ketonuria
- acetone excreted from the lungs, produces the fruity odor to the breath

~symptoms~

  • increased thirst (polydipsia)
  • increased urination (polyuria)
  • fruity odor to breath
  • dry mucous membranes (dehydration)
  • nausea & vomiting
  • increased breathing
  • abdominal pain
  • hypotension

remember, infection is the most common cause of DKA, this is metabolic acidosis, the pH is low and the blood sugar is high

33
Q

symptoms of type 1 diabetes

A 
~ the 3 P’s
- polydipsia
- polyuria
- polyphagia
  • rapid weight loss
  • irritability
  • weakness and fatigue
  • nausea and vomiting
34
Q

symptoms of type 2 diabetes

A

~ possibly the 3 P’s

  • excessive weight gain
  • family hx
  • poor wound healing
  • blurred vision
  • itching
  • drowsiness
  • increased fatigue
  • tingling or numbness in feet
35
Q

symptoms of HYPOglycemia

A
  • headache
  • weakness
  • hunger
  • pallor
  • irritability
  • lack of muscle coordination
  • shakiness
  • apprehension
  • sweating
  • blurred vision
  • tachycardia
  • confusion

ch 37 diabetes (3 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions