Exam 3 ch 46

Question 1

Know what diabetes type I is and what causes it

Answer 1

Destruction of beta calls

Question 2

Know what diabetes type II is and what causes it

Answer 2

inadequate insulin and body’s inability to properly use

Question 3

Know why a patient with type I diabetes would experience hunger, even though the patient is eating large amounts of food

Answer 3

cells can’t use blood glucose

Question 4

Know why a patient with diabetes type I, is at risk for cardiovascular disorders

Answer 4

Increased fatty acids in liver

Question 5

Know how/why “Hyperglycemia” occurs in a diabetic, related to glycogen stores

Answer 5

glycogen is converted to glucose in an attempt to nourish glucose-starved tissues

Question 6

Know how a Nurse would respond to a patient with diabetes, who is having difficulty coping with the disease

Answer 6

Ask about their fears and concerns. open-ended questions

Question 7

Know what a Hemoglobin A1c is and what it measures

Answer 7

shows glucose levels over the last 3 months. more accurate test

Question 8

Know what a Nurse should do if a patient has a low fasting blood sugar at 6 AM in the morning

Answer 8

6-8oz of OJ and/ or feed them

Question 9

Know what “diabetic ketoacidosis” is and what it results in

Answer 9

Life-threatening emergency caused by a relative deficiency or absolute deficiency (lack of insulin). Results in disorder of the metabolism of carbohydrates, fat and protein

• ketones are produced (fruity breath)
• early signs DKA: anorexia, H/A, fatigue

Question 10

If a patient is admitted to a hospital with diabetic ketoacidosis, know what the patients vital signs would show

Answer 10

Elevated pulse (100Beats/M), 
elevated respirations (20 Breaths/M),
Hypothermia (97.4 or lower),

Question 11

Know how exercise would effect a type I diabetic, regarding the patient having hypoglycemia

Answer 11

exercise shortly after eating or snack before if BG is < 100

Question 12

Know what a Nurse would teach on discharge planning, regarding exercise for a type I diabetic

Answer 12

Exercise at the same time and same intensity every day

Question 13

If a Nurse is drawing up two different insulins into the same syringe, know the procedure for drawing two different insulins

Answer 13

Clear (regular) to cloudy (NPH)

Question 14

Know the s/s of hypoglycemia

Answer 14

weakness, hunger, H/A, tachycardia, pallor, diaphoresis, tremors, anxiety, irritability

Question 15

If a patient has a fasting blood glucose of 135, would the Nurse recommend testing for diabetes?

Answer 15

yes; normal BG= 70-120

Question 16

If a patient was taking birth control pills and was on “Avandia”, what caution would the Nurse teach on

Answer 16

Avandia= oral anti-diabetic

-decreases BCP effectiveness, use another back up method

Question 17

For a patient with type I diabetes, who is insulin dependent and is scheduled for a lab draw (to be NPO, prior to lab draw), what would the Nurse do with insulin dosage that is due for the patient

Answer 17

Hold insulin till after lab draw if NPO

Question 18

If a patient admits to the Nurse that they are not compliant with their diabetic diet, how should the Nurse respond?

Answer 18

-open-ended questions.
Why are you not wanting to be compliant?
-Include healthy menu options
-figure out their past eating habits/diet, what they normally eat in 24 hrs.

Question 19

How would a Nurse explain to a type I diabetic why their 7AM insulin was changed to: 70/30 premixed insulin. How would that medication change benefit the patient?

Answer 19

70(NPH)/30(reg)

decreases the risk of error when drawing up 2 insulins in one syringe. It’s easier to prepare

Question 20

Know what a Nurse would include in a diabetes teaching plan regarding exercise?

Answer 20

regular exercise helps control blood glucose levels

Question 21

Know what a patient diagnosed with endogenous hypoglycemia would have?

Answer 21

excessive secretions of insulin

Question 22

Know when Humulin R insulin peaks

Answer 22

Humulin R = regular= peak:2hrs

Question 23

Know what “Somogyi Phenomenon” is and what the patient will exhibit

Answer 23

Too much insulin can cause hyperglycemia (rebound hyperglycemia)

Question 24

Know what “Hyperglycemic hyperosmolar non-ketotic syndrome (HHNS) is, and if caused by large amounts of glucose solutions IV, what would the patient exhibit?

Answer 24

Severe dehydration and hypernatremia

• HHNS=very high BG (800range)
• mortality up to 15%
• lack of effective insulin or defective use of insulin
• no ketones