Diabetes Flashcards
Your patient is a 56-year-old male who is conscious and exhibits slurred speech; irritability; and cool, clammy skin. Blood glucose is 54 mg/dL. Proper treatment for this patient could include all of the following EXCEPT:
A. administration of oral glucose if the patient is able to swallow
B. 5-10 mg of glucagon IM
C. IV of NS
D. consideration of D50 IV if the patient cannot follow simple commands
B.
5-10 mg of glucagon IM
Prehospital management of an unconscious patient with hypoglycemia should NOT include:
A. BVM ventilations with 100% O2 and an OPA
B. administration of oral glucose
C. administration of D50 IV
D. administration of glucagon IM
B
administration of oral glucose
Your patient is a 45-year-old type I diabetic complaining of a 5-day history of abdominal pain, nausea/vomiting, and increased urination and thirst. His skin and mucus membranes are warm and dry. HR=112 bpm and regular, BP=94/60, RR=12 and regular. Your treatment for this patient would most likely include:
A. IV of NS KVO, 50% dextrose IVP
B. IV or NS KVO, nitroglycerin 0.4mg SL, every 3-5 minutes
C. IV of D5W KVO, 50% dextrose IVP
D. IV of NS 1-2L
D
IV of NS 1-2 L
A 24-year-old male is supine on the floor and unconscious with snoring respirations. You note a weak, rapid pulse and cool, diaphoretic skin. HR= 124 and regular, BP= 136/88, RR= 8 and regular. Blood glucose is 24 mg/dL. After manually opening the airway, which of the following is the best sequence of actions?
A. Assist ventilations with a bag-valve-mask and supplemental oxygen, IV of normal saline at a keep-open rate, 25gm dextrose, IV
B. Insert an oropharyngeal airway, assist ventilations with a bag-valve-mask and supplemental oxygen 1 mg glucagon, IM
C. Assist ventilations with a bag-valve-mask and supplemental oxygen, endotracheal intubation, IV of normal saline at a keep-open rate, 25 gm dextrose, IV
D. Insert an oropharyngeal airway, assist ventilations with a bag-valve-mask and supplemental oxygen, IV of D5W, 1mg glucagon, IV
A.
Assist ventilations with a bag-valve-mask and supplemental oxygen, IV of normal saline at a keep-open rate, 25gm dextrose, IV
A chemical substance that is released into the blood by a gland and that controls or affects processes in other glands or body systems is a:
A. Secretion
B. Hormone
C. medication
D. neurotransmitter
B
Hormone
You encounter a patient complaining of polyuria, polyphagia, polydipsia, and abdominal pain. Based on these complaints, which of the following would you also expect to find?
A. Kussmaul’s respirations and a fruity breath odor
B. Complaint of chest pain and shortness of breath
C. Blood glucose between 80-120 mg/dL
D. Blood glucose of less than 70 mg/dL
A.
Kussmaul’s respirations and a fruity breath odor
To which of the following can osmotic diuresis, increased excretion, and ketosis be attributed in a diabetic patient with hyperglycemia?
A. Increased glucose reabsorption in the tubules of the kidney
B. Decreased potassium concentration in the urine
C. Increased flow rate through the tubules of the kidney
D. Increased insulin excretion in the tubules of the kidney
C.
Increased flow rate through the tubules of the kidney
Damage resulting in inactivity to ____ pancreatic cells would result in hyperglycemia.
A. alpha
B. islet
C. delta
D. beta
D.
Beta
Biologically significant quantities of ketone bodies in the blood indicate that:
A. keytone bodies are being used as a primary energy source
B. glucose is not being bused as a primary energy source
C. the lungs are using free acids, resulting in acetone-like smell on the breath
D. glucose metabolism has increased relative to normal hemodynamic states
B.
glucose is not being bused as a primary energy source
Which of the following would you expect to see immediately after the ingestion of a large meal?
A. Increase of blood glucagon and blood glucose levels
B. Decrease of blood glucagon levels followed by an increase of blood insulin levels
C. Increase of blood glucagon levels and a decrease of blood glucose levels
D. Increase of blood glucose and blood insulin levels
D.
Increase of blood glucose and blood insulin levels
A 22-year-old male, uncondcious after a motor vehicle collision, is being cared for by a BLS crew. He is fully immobilized, and ventilations are being provided by bag-valve-mask with an oropharyngeal airway in place. Witnesses report that the patient’s vehicle was traveling on the highway at about 55 miles per hour, then swerved for no apparent reason and drove off the shoulder, rolling over once before coming to rest on its wheels. The patient was initially found in the driver’s seat with his seat belt on. Physical exam reveals some minor abrasions to the patient’s face and shoulders; the airway is clear, the chest, abdomen, extremities, and pelvis are atruamatic (no trauma); bilateral breath sounds are clear and equal. The BLS crew is achieving adequate ventilation with the BVM. HR=112 and regular, BP=132/90, RR=12 and regular, blood glucose=42 mg/dL. Which of the following is the most appropriate initial treatment of this patient?
A. Continue BLS ventilations, cardiac monitor, IV of NS KVO, 50% dextrose IV, reassess
B. Intubate, initiate transport, cardiac monitor and IV access while en route to trauma center
C. Continue BLS ventilations, glucagon 0.5mg IM, reassess
D. Intubate, cardiac monitor, IV or NS KVO, 50% dextrose IV, reassess
A.
Continue BLS ventilations, cardiac monitor, IV of NS KVO, 50% dextrose IV, reassess
A 63-year-old female with a medical history of type II diabetes present with a 4-day history of increased urination and thirst. She called EMS this morning when she experienced a brief period of dizziness while getting out of bed. Your assessment reveals a BP of 108/60, RR of 14/min and regular, and a HR of 122 and regular. YOu also note that the patient is slightly confused and has warm, dry skin and mucus membranes. Based on this patient presentation, what other findings could you expect?
A. Glucosuria
B. Atrial flutter
C. Fruity breath odor
D. A blood glucose of 68 mg/dL
A.
Glucosuria (Sugar in pee)
A type I diabetic patient who ____ is NOT likely to experience hypoglycemia.
A. snacks on a candy bar between meals
B. administers too much insulin
C. skips a meal and administers insulin as normal
D. starts an exercise program, exerting more than usual
A.
snacks on a candy bar between meals
A type II diabetic with a blood glucose of 24 mg/dL would most likely be unconscious due to:
A. insulin shock
B. gluconeogenesis
C. cerebral hypoglycemia
D. diabetic ketacidosis
C.
cerebral hypoglycemia
A 68-year-old female is supine in bed at a rehabilitation hospital. She is unresponsive and has gurgling respirations. Staff reports that the patient is at the facility recovering from right hip replacement surgery performed 14 days prior and has had a worsening infection at the surgery site over the past 7 days. Staff also reports that the patient had a slight altered mental status yesterday and was found unconscious this morning. Physical exam reveals an accumulation of secrestions in her airway, lung sounds clear and equal bilaternally, and skin and mucus membranes warm and dry. You also note erythema and a purulent discharge from a surgical incision on her right hip. HR=119 and irregular, BP=86/58, RR=10 and shallow, blood glucose=864 mg/dL. Which of the following is the best treatment for this patient?
A. Suction the airway,initiate BVM ventilations with 100% oxygen and an oropharyngeal airway, cardiac monitor, IV of NS KVO, rapid transport
B. Suction the airway, oxygen 15 lpm via nonrebreather mask, cardiac monitor, IV of NS 1-2L, rapid transport.
C. Suction the airway, initiate BVM ventilations with 100% oxygen and an oropharyngeal airway, intubate, cardiac monitor, IV of NS 1-2L, rapid transport
D. Suction the airway, initiate BVM ventilations with 100% oxygen and an oropharyngeal airway, intubate, cardiac monitor, IV of NS 1-2L, 50% dextrose IV, rapid transport
C.
Suction the airway, initiate BVM ventilations with 100% oxygen and an oropharyngeal airway, intubate, cardiac monitor, IV of NS 1-2L, rapid transport
