Diabetes

Question 1

regular A1C

Answer 1

4-5.6%

Question 2

fasting glucose

Answer 2

74-106

Question 3

normal breathing rate

Answer 3

12-20

Question 4

normal beats per minute

Answer 4

60-100

Question 5

A1C reflects glucose over

Answer 5

2-3 months

Question 6

hypoglycemia produces _________ symptoms

Answer 6

autonomic nervous system symptoms

(tremors, irritability, nervousness, faint/dizzy, cold/clammy skin, tachy, numbness in fingers/toes/mouth, hunger, sweating)

Question 7

When other assessments are normal, a high temp could indicate infection, which can lead to

Answer 7

HHS (Hyperosmolar hyperglycemic syndrome)

Question 8

Hypoglycemic reactions to insulin treatment most likely occur during _____ time

Answer 8

peak time

Question 9

When the client is under stress, such as when an infection is present, an increase in the dose of insulin will be required to

Answer 9

facilitate the transport of excess glucose into the cells.

Question 10

rapid acting insulin onset, peak and duration

Answer 10

onset 10 to 30 min
peak 30 min to 3 hrs
duration 3 to 5 hrs

Question 11

short acting insulin onset, peak, and duration

Answer 11

onset 30 min to 1 hr
peak 2 to 5 hr
duration 5 to 8 hrs

Question 12

intermediate acting insulin onset, peak and duration

Answer 12

onset 1.5 to 4 hrs
peak 4 to 12 hrs
duration 12-18 hrs

Question 13

long acting insulin onset, peak and duration

Answer 13

onset 0.8 to 4 hrs
peak less defined/not pronounced
duration 16-24 hrs

Question 14

lispro (Humalog)
aspart (Novolog, Fiasp)
gluilsine (Apidra)

Answer 14

rapid acting insulin

Question 15

Regular (Humulin R, Novolin R)

Answer 15

short acting insulin

Question 16

NPH (Humulin N, Novolin N)

Answer 16

intermediate acting insulin

Question 17

glargine (Lantus, Toijeo, Basaglar)
detemir (Levemir)
degludec (Tresiba)

Answer 17

long acting insulin

Question 18

laboratory values in HHS include

Answer 18

Glucose level greater than 600 mg/dL (33.33 mmol/L)

A marked increase in serum osmolality

Absent or minimal ketone bodies in both blood and urine

Question 19

HHS intervention includes when glucose levels fall to about 250 mg/dL (13.9 mmol/L), IV fluids containing

Answer 19

dextrose are given to prevent hypoglycemia

Question 20

Intervention for HHS includes Immediate IV administration of insulin and either

Answer 20

0.9% or 0.45% NaCl

(Usually requires large volumes of fluid replacement which should be done slowly and carefully)

Question 21

Patients with HHS are often older and may have

Answer 21

heart or kidney problems, requiring hemodynamic monitoring to avoid fluid overload.

Question 22

Avoid hypoglycemia treatment with carbohydrates that contain fat, such as candy bars, cookies, whole milk, and ice cream. The fat in those foods will

Answer 22

slow glucose absorption and delay the response to treatment

Question 23

If no significant improvement occurs after 2 or 3 doses of “the rule of 15,”

Answer 23

contact HCP

Question 24

manifestations of diabetic nephropathy

Answer 24

high bp

ankle/leg swellilng

elevated serum creatinine

Question 25

manifestations of hypoglycemia

Answer 25

mood swings difficulty speaking increased hr pale skin/pallor sweating tachy headache anxiety vision changes tremors numbness in fingers and toes I'M COLD, SWEATY AND CLAMMY, GIVE ME SOME CANDY

Question 26

_________ is one of the most common illnesses that trigger HHS.

Answer 26

pneumonia

Question 27

HHS commonly occurs in patients with type _______ diabetes who have some concomitant illness that leads to reduced __________

Answer 27

type 2 reduced fluid intake

Question 28

Patients with pneumonia most often present with

Answer 28

hyperglycemia as a result of the stress response releasing more glucose into the blood to help fight the infection.

Question 29

DKA is a complication seen in patients with type _____ diabetes, not type _____ diabetes.

Answer 29

type 1 not type 2

Question 30

When a patient has symptoms of hypoglycemia, the nurse should follow the

Answer 30

“Rule of 15” by giving the patient 15 g of simple (fast-acting) carbohydrates to increase the blood glucose level.

Question 31

When a patient exhibits signs of DKA the nurse should

Answer 31

check the patient's capillary glucose level and notify the HCP

Question 32

Fat does not allow glucose to increase to

Answer 32

eliminate symptoms of hypoglycemia need carbs

Question 33

An extra does of rapid-acting insulin during hypoglycemia would

Answer 33

further decrease the glucose level

Question 34

hyperglycemia symptoms

Answer 34

polyuria polyphagia polydypsia dry mouth weight loss blurred vision

Question 35

proliferative retinopathy

Answer 35

seeing red and black spots

Question 36

nonproliferative retinopathy

Answer 36

can cause some vision loss but does not usually cause spots

Question 37

Tachycardia at rest, postural hypotension, decreased libido, and painless miocardial infarction are expected in a patient with

Answer 37

autonomic neuropathy

Question 38

In which diabetes type can macroangiopathy occur?

Answer 38

Both

Question 39

Macroangiopathy contributes to

Answer 39

cerebrovascular, cardiovascular, and peripheral vascular disease

Question 40

when microangiopathy affects the eyes its called

Answer 40

retinopathy

Question 41

when microangiopathy affects the kidneys its called

Answer 41

nephropathy

Question 42

when microangiopathy affects the skin it can lead to

Answer 42

diabetic foot ulcers

Question 43

Sexual impotency and slowed gastric emptying result from

Answer 43

microangiopathy and neuropathy

Question 44

Renal damage resulting from changes in small-sized blood vessels can be prevented by

Answer 44

careful glucose control.

Question 45

___________ is the most common skin lesion in diabetic patients

Answer 45

Dermopathy

Question 46

_________ is characterized by reddish-brown, round or oval patches that are scaly initially and then flatten out. They are common on shins but can also appear in other places.

Answer 46

dermopathy

Question 47

Acanthosis nigricans is a manifestation of

Answer 47

insulin resistance that appears as velvety light brown to black skin thickening.

Question 48

This condition appears as red-yellow lesions, with atrophic skin that becomes tiny and transparent.

Answer 48

Necrobiosis lipoidica diabeticorum

Question 49

aphasia is a symptom of

Answer 49

HHS (and other disease processes)

Question 50

glaucoma may develop due to

Answer 50

retinopathy

Question 51

Paresthesia is a symptom of

Answer 51

sensory neuropathy

Question 52

gastroparesis is one example of

Answer 52

autonomic neuropathy

Question 53

symptoms of autonomic neuropathy

Answer 53

gastroparesis postural hypotension silent MI ED neurogenic bladder hypoglycemia unawareness

Question 54

beta blockers can mask

Answer 54

hypoglycemia

Question 55

what drug should be given to a patient with type 2 diabetes and the presence of albumin in the urine?

Answer 55

presence of albumin in the urine indicates nephropathy in patients with diabetes angiotensin-converting enzyme inhibitors such as linsinopril may delay the progression of nephropathy in diabetic patients

Question 56

the presence of albumin in the urine indicates _______ in patients with diabetes

Answer 56

nephropathy

Question 57

duloxetine is a selective serotonin reuptake inhibitor that is used for symptomatic treatment of

Answer 57

sensory neuropathy

Question 58

pregabalin is an antisiezure med used for

Answer 58

neuropathic pain in diabetic patients

Question 59

bethanechol is a cholinergic agonist that is indicated for the treatment of

Answer 59

neurogenic bladder

Question 60

manifestations of hyperglycemia

Answer 60

increased urination abdominal cramps nausea and vomitting

Question 61

Administration of which prescribed intervention may help to prevent further complications in an unconscious patient with hypoglycemia (65 mg/dL) and no IV access?

Answer 61

infusion of 0.9% sodium chloride (NaCl)

Question 62

route for glargine is

Answer 62

subcutaneously only

Question 63

Peripheral Arterial Disease (PAD) symptoms

Answer 63

cold feet loss of hair dependent rubor

Question 64

Peripheral arterial disease causes diseased blood to flow to

Answer 64

the lower extremities

Question 65

urinary retention and bowel incontinence are symptoms of

Answer 65

autonomic neuropathy

Question 66

What treatment will reduce serum ketones for a patient in DKA?

Answer 66

insulin therapy is useful for reducing serum ketone levels

Question 67

when the body cannot utilize glucose for energy it

Answer 67

burns fat for energy, resulting in the production of ketones

Question 68

electrolytes are given to correct

Answer 68

electrolyte imbalance

Question 69

sodium bicarbonate is given to treat

Answer 69

metabolic acidosis, but does not reduce ketones

Question 70

IV fluids are indicated for correction of

Answer 70

dehydration

Question 71

what happens to potassium in the presence of insulin?

Answer 71

decrease, moves from blood to cells

Question 72

what happens to potassium in the presence of acidosis?

Answer 72

increases, moves out of cells into blood as hydrogen moves out of blood into cells

Question 73

what happens to potassium in the presence of alkalosis?

Answer 73

decreases, moves into cells out of the blood as hydrogen moves out of cells into the blood

Question 74

how many mg in a g

Answer 74

1,000

Question 75

how many mcg in a g

Answer 75

1,000,000

Question 76

how many lb is 1 kg

Answer 76

1 kg = 2.2 lbs

Question 77

Symptoms, manifestations, and assessment findings of DKA

Answer 77

lethargy frequent urination nausea and vomiting low bp dry mucous membranes weakness mild disorientation history of type 1 dehydration soft and sunken eyes sweet fruity odor of breath skin flushed and dry Kussmaul respirations (deep and fast)/hyperventilation to correct acid-base imbalance to remove CO2

Question 78

symptoms, manifestations, and assessment findings of HHS

Answer 78

altered level of consciousness profound dehydration triggers increased cardiac output (tachy) hypotension cool, clammy skin severe drowsiness seizures excessive fluid loss/urination aphasia and hemiparesis can resemble stroke, important to check blood glucose

Question 79

the ______ is the organ responsible for producing insulin

Answer 79

pancreas

Question 80

hypoglycemia is fasting glucose less than

Answer 80

70

Question 81

diagnostics to rule in DM

Answer 81

A1C 6.5% or higher elevated fasting plasma glucose (FPG) abnormal Glucose Tolerance Test (GTT) classic symptoms of hyper or hypo glycemia, or a random blood glucose of greater than 200 mg/dL

Question 82

insulin subq sites

Answer 82

abdomen, anterior thigh, posterior upper arm, upper buttock

Question 83

we never give intermediate or long acting insulin by ______

Answer 83

IV