Endocrine Flashcards
The nurse is teaching a 12-year-old child about the action of insulin injections. Which statement indicates the child understands how insulin works in the body?
A. ‘Glucose is released as fats break down.’
B. ‘It keeps glucose from being stored in the liver.’
C. ‘Glucose is carried into cells where it is used for energy.’
D. ‘It stops the wasting of blood glucose by converting it to glycogen.’
C. ‘Glucose is carried into cells where it is used for energy.’
Specialized insulin receptors on insulin-sensitive cells transport glucose through cell membranes, making it available for use. Insulin does not break down fats to release glucose, prevent glucose from being stored in the liver, or convert glucose into glycogen.
A client states, ‘I keep my insulin in the refrigerator because that is where my parents
kept it.’ Which reason will the nurse include when explaining why insulin should be
stored at room temperature?
A. Its potency and effectiveness are maximized.
B. Absorption is enhanced and local irritation is decreased.
C. It is more convenient and drawing insulin into the syringe is facilitated.
D. Adherence of insulin to the syringe and resistance upon injection are decreased.
B. Absorption is enhanced and local irritation is decreased.
Insulin that is close to body temperature prevents vasoconstriction at the site and
decreases irritation of tissues. Insulin can be stored at room temperature for up to 1
month but must be kept away from heat or sunlight. Inappropriate storage of insulin
can decrease its stability and decrease, not increase, its therapeutic action.
Several hours after administering insulin, the nurse assesses the client’s response to the insulin. Which client responses are NOT indicative of a hypoglycemic reaction?
A. Tremors
B. Anorexia
C. Confusion
E. Diaphoresis
B. Anorexia
Confusion is typically the first sign of a hypoglycemic reaction. Tremors are a sympathetic nervous system response that occurs because circulating glucose in the brain decreases. Diaphoresis is a cholinergic response to hypoglycemia. Hypoglycemia causes hunger, not anorexia.
Which finding would lead the nurse to NOT recheck the blood glucose level of a diabetic client before administering a mealtime insulin dose?
A. Confusion
B. Thirst
C. Diaphoresis
D. Nervousness
B. Thirst
Thirst is a sign of hyperglycemia not hypoglycemia. Signs of hypoglycemia include confusion, drowsiness, diaphoresis, nervousness, tachycardia, and headache.
The nurse is caring for a client with type 1 diabetes. Which signs or symptoms may indicate that the client does NOT have insulin-induced hypoglycemia?
A. Excessive hunger
B. Weakness
C. Diaphoresis
D. Deep respirations
D. Deep respirations
Deep respirations (Kussmaul respirations) are associated with hyperglycemia because the body is attempting to blow off carbon dioxide to compensate for the metabolic acidosis.
The nurse concludes that a client has a hypoglycemic reaction to insulin. Which clinical findings support this conclusion?
A. Diaphoresis
B. Glycosuria
C. Dry, hot skin
D. Fruity odor of breath
A. Diaphoresis
Irritability, a neuroglycopenic symptom, occurs when the glucose in the brain declines to a low level. Heart palpitations, a neurogenic symptom, occur when the sympathetic nervous system responds to a rapid decline in blood glucose.
A nurse is caring for a client who has type 1 diabetes mellitus. The nurse misread the client’s morning blood glucose level as 210 mg/dL instead of 120 mg/dL and administered the insulin dose appropriate for a reading over 200 mg/dL before the client’s breakfast. Which of the following actions is the nurse’s priority?
A. Give the client 15 to 20 g of carbohydrate.
B. Monitor the client for hypoglycemia.
C. Complete an incident report.
D. Notify the nurse manager.
B. Monitor the client for hypoglycemia.
The first action the nurse should take using the nursing process is to assess or collect data from the client. The nurse should immediately check the client’s blood glucose level, expecting it to be low because of the excessive dose of insulin. If it is within the expected reference range, the nurse should continue to monitor the client for signs of hypoglycemia.
