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Nursing III > Diabetes Exam > Flashcards

Diabetes Exam Flashcards

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1
Q

Glucose in the urine is called ______

A

glycosuria

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2
Q

_______ is too much sugar in the blood

A

Hyperglycemia

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3
Q

______ is too little sugar in the blood

A

Hypoglycemia

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4
Q

Deep, sighing respirations from diabetic acidosis are called ______ respirations

A

Kussmaul’s

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5
Q

Excessive hunger is called ?

A

Polyphagia

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6
Q

Excessive thirst is called ?

A

Polydipsia

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7
Q

The patient who gets up to urinate at night has _____

A

nocturia

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8
Q

The time when insulin is working its hardest after injection is called its ____ action time

A

peak

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9
Q

The length of time insulin works is called its _____

A

duration

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10
Q

Symptoms of hyperglycemia

A

Polydipsia, polyuria, lethargy, fruity breath, abdominal pain

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11
Q

Symptoms of hypoglycemia

A

Tremor, irritability, sweating

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12
Q

Impaired vision

A

Retinopathy

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13
Q

Burning pain in legs and feet

A

Neuropathy

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14
Q

Profound hyperglycemia without ketonemia

A

Hyperosmolar hyperglycemia

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15
Q

Ketones in the blood and urine

A

DKA

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16
Q

Food intolerance

A

Gastroparesis

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17
Q

Which of the following is an acceptable pre-meal blood sugar range for a patient with diabetes?

a) 46 to 98
b) 70 to 130
c) 180 to 250
d) 350 to 600

A

b) 70 to 130 mg/dL

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18
Q

Before giving insulin, the nurse always checks which test result?

a) Recent potassium level
b) Blood sugar level
c) Urine ketones
d) White blood cell count

A

b) Blood sugar level

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19
Q

At what point after injection does the peak action of regular insulin occur?

a) 30 to 60 minutes
b) 1 to 2 hours
c) 2 to 5 hours
d) 8 to 12 hours

A

c) 2 to 5 hours

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20
Q

Which of the following are symptoms of hypoglycemia?

a) Nausea and vomiting
b) Glycosuria
c) Cold sweat and tremor
d) Polyuria and polydipsia

A

c) Cold sweat and tremor

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21
Q

In addition to stimulating insulin production, glyburide (Micronase) has which of the following effects?

a) Stimulates gluconeogenesis
b) Promotes fat breakdown
c) Increases tissue sensitivity to insulin
d) Enhances appetite

A

c) Increases tissue sensitivity to insulin

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22
Q

A 26-year-old patient is admitted to the hospital with a new diagnosis of diabetes, a blood glucose of 680 mg/dL, and ketones in the blood and urine. Which type of diabetes should the nurse suspect?

a) Type 1
b) Type 2
c) Prediabetes
d) Gestational

A

a) Type 1

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23
Q

A 45-year-old with diabetes forgot to take a daily dose of glyburide (Micronase). For which of the following symptoms should the nurse be vigilant?

a) Cold, clammy sweat
b) Tachycardia, nervousness, hunger
c) Chest pain, shortness of breath
d) Fatigue, thirst, blurred vision

A

d) Fatigue, thirst, blurred vision

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24
Q

By which routes can insulin be administered? (Select all that apply)

a) Oral
b) Topical
c) Intravenous
d) Subcutaneous
e) Intramuscular

A

c, d, e

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25
Q

While providing discharge instructions to a patient newly taking NPH insulin every morning, the nurse recognizes that teaching has been effective if the patient knows to observe for signs and symptoms of low blood sugar level at which of the following times?

a) 1 hour after administration of insulin
b) 6 to 12 hours after administration of insulin
c) 24 to 36 hours after administration of insulin
d) NPH insulin does not cause low blood sugar level

A

b) 6 to 12 hours after administration of insulin

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26
Q

A patient with newly diagnosed diabetes asks the nurse what to take for low blood sugar. Which of the following would be most appropriate for the nurse to suggest?

a) Raisins
b) Cheese
c) acetaminophen (Tylenol)
d) Beef jerky

A

a) Raisins

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27
Q

The nurse recognizes that teaching is effective if a patient with diabetes knows to use subcutaneous glucagon for an emergency episode of which of the following conditions?

a) Hyperglycemia
b) Ketonuria
c) DKA
d) Hypoglycemia

A

d) Hypoglycemia

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28
Q

A patient on an American Diabetes Association diet receives a breakfast tray and does not care for the oatmeal. Which of the following foods can the nurse substitute for a half cup of oatmeal?

a) 4 oz of orange juice
b) Two strips of bacon
c) 1 oz of cheese
d) A slice of wheat toast

A

d) A slice of wheat toast

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29
Q

Which of the following is the best definition of diabetes mellitus?

a) It is a disease in which high blood glucose results from defective insulin secretion or action
b) It is a disease that causes polyuria and polydipsia
c) It is a disease characterized by macrovascular and microvascular complications
d) It is a complex disease of protein and fat metabolism

A

a) It is a disease in which high blood glucose results from defective insulin secretion or action

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30
Q

Which of the following is a risk factor for type 2 diabetes mellitus?

a) Cardiovascular disease
b) Obesity
c) Age younger than 40 years
d) Virus exposure

A

b) Obesity

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31
Q

Diabetes is diagnosed when the fasting blood glucose is greater than ___ mg/dL

A

126

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32
Q

Place the steps for mixing insulin in correct sequential order?

a) Draw up cloudy insulin
b) Draw up clear insulin
c) Roll cloudy vial
d) Inject air into cloudy insulin
e) Inject air into clear insulin
f) Clean vial tops with alcohol

A

c) Roll cloudy vial
f) Clean vial tops with alcohol
d) Inject air into cloudy insulin
e) Inject air into clear insulin
b) Draw up clear insulin
a) Draw up cloudy insulin

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33
Q

Which of the following symptoms is most commonly associated with hyperglycemia?

a) Tremor
b) Flank pain
c) Sweating
d) Polyuria

A

d) Polyuria

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34
Q

Protein in the urine is a sign of which long-term complication of diabetes?

a) Nephropathy
b) Neuropathy
c) Retinopathy
d) Gastroparesis

A

a) Nephropathy

35
Q

What is the best way for patients to avoid long-term complications of diabetes?

a) See the doctor for a complete checkup every 6 months
b) Check feet daily
c) Maintain premeal blood glucose levels under 130 mg/dL
d) Follow a strict meal plan for diabetes

A

c) Maintain premeal blood glucose levels under 130 mg/dL

36
Q

Which breakfast menu is most appropriate for a patient with diabetes?

a) Two eggs, two strips bacon, orange juice, coffee
b) Oatmeal with artificial sweetener, whole-grain toast, tea
c) One half grapefruit, cranberry juice, bagel with sugar-free jelly
d) One slice whole-grain toast with peanut butter, skim milk, orange juice

A

d) One slice whole-grain toast with peanut butter, skim milk, orange juice

37
Q

For which of the following blood glucose results would the nurse administer a fast sugar?

a) 48
b) 80
c) 126
d) 223

A

a) 48

38
Q

A patient who is preparing for surgery asks the nurse why his physician took him off his oral hypoglycemic and placed him on sliding-scale insulin. Which response by the nurse is the best?

a) “It helps us maintain better control of your blood glucose during surgery. You will most likely be back on your pills before you go home.”
b) “The stress of surgery often exacerbates diabetes. We will teach you how to give insulin before you go home.”
c) “Oral hypoglycemic are ineffective during times of stress. Insulin is the only way to keep your blood glucose under control.”
d) “The oral agents must not be controlling your blood glucose any longer. I will check and see which insulin you will be going home on.”

A

a) “It helps us maintain better control of your blood glucose during surgery. You will most likely be back on your pills before you go home.”

39
Q

Which meal plan is best for the patient with reactive hypoglycemia?

a) High-carbohydrate meals
b) Small, frequent meals
c) Avoidance of fats and proteins
d) Three medium to large meals daily

A

b) Small, frequent meals

40
Q

Cells and body tissues use ____ for energy

A

glucose

41
Q

____ is a simple sugar provided by the foods we eat

A

Glucose

42
Q

_____ provide most of the glucose for the cells in the body

A

Carbohydrates

43
Q

_____ and _____ work together to maintain blood glucose levels

A

insulin, glucagon

44
Q

When glucose cannot be utilized properly, _____ is diagnosed

A

diabetes

45
Q

Glucose can only enter cells with help of _____

A

insulin

46
Q

The hormone insulin is produced by beta cells in ____ ___ ______ of the pancreas

A

islets of Langerhans

47
Q

Some insulin is made by the pancreas, but not enough. Sometimes the pancreas makes enough insulin but the cells are resistant to it. Characterized by hyperglycemia on lab value (blood and urine)

A

Type 2 diabetes

48
Q

Defined as carbohydrate intolerance occurring during pregnancy. It is due to extra metabolic demands that pregnancy triggers

A

Gestational Diabetes Mellitus (GDM)

49
Q

______ refers to blood glucose levels that are above normal, but do not meet the criteria for diagnosing diabetes

A

Prediabetes

50
Q

Develops due to another chronic illness that damages the islet cells such as pancreatitis and cystic fibrosis. May be the result of medication use (most commonly steroids)

A

Secondary diabetes

51
Q

When a patient has 3 or more of the following metabolic abnormalities: HTN, increased cholesterol, low HDL (below 40), increased triglycerides, obesity, fasting glucose greater than 100

A

Metabolic Syndrome or Syndrome X

52
Q

Classic signs and symptoms of Diabetes

A

Polyuria, polydipsia, polyphagia

53
Q

Below 100 mg/dL for a nondiabetic, or for a diabetic with good glucose control

A

Normal fasting blood glucose

54
Q

This is when the blood is checked with no regards to the last meal. It is done randomly. Diabetes is diagnosed if this level is 200 or above and have signs and symptoms of diabetes with it

A

Casual plasma glucose

55
Q

A loading dose of carbohydrates are given and the blood glucose is measured at intervals afterwards. This test evaluates insulin response to glucose loading. If diabetic, the patient will have greatly elevated glucose levels for 1-5 hours after glucose load

A

OGTT - Oral glucose tolerance test

56
Q

What are the patient considerations for fasting lab draws?

A
  • For fasting glucose pt must fast from any caloric intake for at least 8 hours (overnight) sips of water are allowed
  • Advise patient to refrain from smoking before the glucose sampling
  • Hold insulin or oral anti-hyperglycemic medications
  • For postprandial test, advise patient that no food should be eaten during the 2 hour interval
  • Check lab results before administering medication or food
57
Q

Normal HbA1C is _ to _ %

A

4 to 5

58
Q

This better determines the average blood glucose, rather than one single fasting blood sugar would
Blood glucose attaches itself to hemoglobin and forms glycohemoglobin
AKA: Glycated hemoglobin, Glycohemoglobin, Glycosylated hemoglobin
**This test will be inaccurate with those patients that have anemia

A

HbA1C

59
Q

Capillary blood glucose values obtained by ___ ___ samples tend to be higher than values in venous samples

A

finger stick

60
Q

Do you aspirate or rub sire after an injection of insulin

A

NO!

61
Q

Injection sites are to be ____ in order to avoid injury to the tissues

A

rotated

62
Q

This medication is used for type 2 diabetes
The action is to either increase the production of insulin, or decreases glucose production by the liver.
Also used in conjunction with insulin.
Most need to be administered before a meal

A

Oral hypoglycemics

63
Q

Block enzymes that digest starches

A

Alpha-Glucose Inhibitors

64
Q

Slow the rate at which the liver releases glucose

A

Biguanides

65
Q

Make the pancreas release more insulin in a more rapid manner than other oral agents

A

Meglitinides

66
Q

Stimulate the pancreas to produce more insulin. They assist insulin in moving glucose into cells

A

Sulfonylureas

67
Q

Assist muscle utilization of insulin produced by the body

A

Tiazolidinediones (TZDs)

68
Q

Usually referred to when blood glucose is below 50

A

Hypoglycemia

69
Q

What are some fast carbohydrates to give someone when they have low blood sugar (hypoglycemia)

A

4 oz OJ, hard candy, soda, raisins, glucose tablets, milk

70
Q

______ _____ is an acute complication of diabetes mellitus (usually type 1) characterized by hyperglycemia, ketonuria, acidosis, dehydration, hyperkalemia

A

Diabetic ketoacidosis (DKA)

71
Q

This is a complication of diabetes type 2
It also primarily occurs in the elderly
As the blood glucose rises, polyuria causes dehydration producing the hyperosmolar (concentrated) state
Signs and symptoms: extreme thirst, lethargy and confusion

A

Hyperosmolar-Hyperglycemia-Nonketotic Syndrome (HHNK)

72
Q

Due to vascular complications, neuropathy and infection risk, diabetics are at extreme high risk for ____ complications

A

foot

73
Q

This type of hypoglycemia occurs in the patient that is not diabetic. It is believed to be caused by the overreaction of the pancreas to eating. The pancreas senses a rise in blood glucose and produces more insulin than is necessary

A

Reactive hypoglycemia

74
Q

what 2 insulins cannot be mixed with other insulins?

A

Glargine (Lantus) and detemir (Levemir)

75
Q 
Insulin lispro (Humalog)
Insulin aspart (Novolog)
Insulin glulisine (Apidra)
A

Very short acting insulin

76
Q

Regular (Humulin R, Novolin R)

A

Short acting insulin

77
Q

NPH (Humulin N, Novolin N)

A

Intermediate acting insulin

78
Q 
Insulin glargine (Lantus AE)
Insulin detemir (Levemir)
A

Basal insulin

79
Q

When mixing insulins, remember ___ to ____

A

clear to cloudy

80
Q

What is basal-bolus insulin?

A

This consists of an injection of a basal insulin (such as Lantus) once a day, often at bedtime, to provide a constant small amount of insulin in the bloodstream

81
Q

____-_____ of ____ ___ (SMBG) usually is done before meals and at bedtime by the person on insulin who wants to maintain tight control of blood glucose

A

self-monitoring of blood glucose

82
Q

______ ________ (DKA) occurs when blood glucose levels become very high and insulin is deficient

A

diabetic ketoacidosis

83
Q

The combination of vascular disease, neuropathy, and risk for infection makes patients with diabetes prone to ____ problems

A

foot

84
Q

Tiny amounts of protein in the urine

A

microalbuminuria

Nursing III (6 decks)

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