Final Exam uWu Flashcards
Propranolol (Inderal) is prescribed for a patient diagnosed with hypertension. The nurse should consult with the health care provider before giving this medication when the patient reveals a history of
a. asthma.
b. daily alcohol use.
c. peptic ulcer disease.
d. myocardial infarction (MI).
a. asthma
The high-pressure alarm on a patient’s ventilator goes off. When the nurse enters the room to assess the patient, who has acute respiratory distress syndrome (ARDS), the oxygen saturation monitor reads 87% and the patient is struggling to sit up. Which action should the nurse take first?
A) Reassure the patient that the ventilator will do the work of breathing for him.
B) Manually ventilate the patient while assessing possible reasons for the high-pressure alarm.
C) Increase the fraction of inspired oxygen (Fio2) on the ventilator to 100% in preparation for endotracheal suctioning.
D) Insert an oral airway to prevent the patient from biting on the endotracheal tube.
B) Manually ventilate the patient while assessing possible reasons for the high-pressure alarm.
Rationale:
Manual ventilation of the patient will allow the nurse to deliver an Fio2 of 100% to the patient while attempting to determine the cause of the high-pressure alarm. The patient may need reassurance, suctioning, or insertion of an oral airway, but the first step should be assessing the reason for the high-pressure alarm and resolving the hypoxemia.
A patient diagnosed with hypertension has been prescribed captopril. Which information is most important to teach the patient about this drug?
A. Include high-potassium foods such as bananas in the diet
B. Change position slowly to help prevent dizziness and falls
C. Increase fluid intake if dryness of the mouth is a problem
D. Check the blood pressure in both arms before taking the drug
B. Change position slowly to help prevent dizziness and falls
A patient who was admitted with a myocardial infarction experiences a 45-second episode of ventricular tachycardia, then converts to sinus rhythm with a heart rate of 98 beats/minute. Which of the following actions should the nurse take next?
a. Immediately notify the health care provider.
b. Document the rhythm and continue to monitor the patient.
c. Perform synchronized cardioversion per agency dysrhythmia protocol.
d. Prepare to give IV amiodarone (Cordarone) per agency dysrhythmia protocol.
D. Prepare to give IV amiodarone (Cordarone) per agency dysrhythmia protocol.
The burst of sustained ventricular tachycardia indicates that the patient has significant ventricular irritability, and antidysrhythmic medication administration is needed to prevent further episodes. The nurse should notify the health care provider after the medication is started. Defibrillation is not indicated given that the patient is currently in a sinus rhythm. Documentation and continued monitoring are not adequate responses to this situation
A nurse is caring for a patient with ARDS who is being treated with mechanical
ventilation and high levels of positive end-expiratory pressure (PEEP). Which assessment finding by the nurse indicates that the PEEP may need to be reduced?
a. The patient’s PaO2 is 50 mm Hg and the SaO2 is 88%.
b. The patient has subcutaneous emphysema on the upper thorax.
c. The patient has bronchial breath sounds in both the lung fields.
d. The patient has a first-degree atrioventricular heart block with a rate of 58 beats/min.
b. The patient has subcutaneous emphysema on the upper thorax.
The subcutaneous emphysema indicates barotrauma caused by positive pressure ventilation and PEEP.
Bradycardia, hypoxemia, and bronchial breath sounds are all concerns and will need to be addressed, but
they are not specific indications that PEEP should be reduced.
When assessing a patient with ARF, the nurse finds a new onset of agitation and confusion. Which action should the nurse take first?
a. Check pupils for reaction to light.
b. Notify the health care provider.
c. Attempt to calm and reorient the patient.
d. Assess oxygenation using pulse oximetry.
d. Assess oxygenation using pulse oximetry.
Because agitation and confusion are frequently the initial indicators of hypoxemia, the nurse’s initial
action should be to assess O2
saturation. The other actions are also appropriate, but assessment of
oxygenation takes priority over other assessments and notification of the health care provider.
The nurse assesses vital signs for a patient admitted 2 days ago with gram-negative sepsis: temperature of 101.2° F, blood pressure of 90/56 mm Hg, pulse of 92 beats/min, and respirations of 34 breaths/min. Which action should the nurse take next?
a. Give the scheduled IV antibiotic.
b. Give the PRN acetaminophen (Tylenol).
c. Obtain oxygen saturation using pulse oximetry.
d. Notify the health care provider of the patient’s vital signs.
c. Obtain oxygen saturation using pulse oximetry.
The patient’s increased respiratory rate in combination with the admission diagnosis of gram-negative sepsis indicates that acute respiratory distress syndrome (ARDS) may be developing. The nurse should
check for hypoxemia, a hallmark of ARDS. The health care provider should be notified after further
assessment of the patient. Giving the scheduled antibiotic and the PRN acetaminophen will also be done,
but they are not the highest priority for a patient who may be developing ARDS.
The nurse correlates the P wave on the ECG tracing to which cardiac action?
a) Repolarization of the purkinje fibers
b) Repolarization of the ventricles
c) Depolarization of the atria
d) Depolarization of the ventricles
c) Depolarization of the atria
A patient with acute respiratory distress syndrome (ARDS) and acute kidney injury has the following drugs ordered. Which drug should the nurse discuss with the health care provider before giving?
a. gentamicin 60 mg IV
b. pantoprazole (Protonix) 40 mg IV
c. sucralfate (Carafate) 1 g per nasogastric tube
d. methylprednisolone (Solu-Medrol) 60 mg IV
a. gentamicin 60 mg IV
Gentamicin, which is one of the aminoglycoside antibiotics, is potentially nephrotoxic, and the nurse should clarify the drug and dosage with the health care provider before administration. The other drugs are appropriate for the patient with ARDS
When analyzing a patient’s electrocardiogram, the nurse correlates which information as descriptive of a normal P wave?
a. ) Represents conduction through the AV node
b. ) Represents ventricular depolarization
c. ) The height of the P wave is 4 mm
d. ) The P length is 0.10 seconds
d.) The P length is 0.10 seconds
What does the P wave represent?
Atrial depolarization
What does the QRS complex represent?
Ventricular depolarization
What does the T wave represent?
Ventricular repolarization
A patient is being evaluated for a blockage in the cardiac ventricles. The nurse assesses which part of the ECG as evidence of this blockage?
a. ) T wave
b. ) U wave
c. ) PR interval
d. ) QRS interval
d.) QRS interval
The nurse prepares to administer which prescribed medication to the patient with shortness of breath and a heart rhythm of 46 beats per minute?
a. ) Atropine sulfate
b. ) Atenolol
c. ) Diltiazem
d. ) Adenosine
a.) Atropine sulfate
The nurse provides care to a patient who is prescribed IV adenosine. Which is the priority nursing action before administering the medication?
a. ) Monitoring respirations
b. ) Palpating the patient’s pulse
c. ) Teaching the patient to avoid caffeine intake
d. ) Ensuring a transcutaneous pacemaker is available
d.) Ensuring a transcutaneous pacemaker is available
The nurse is preparing to defibrillate a patient and selects which setting before the first shock?
a. ) 50 J
b. ) 100 J
c. ) 150 J
d. ) 200 J
d.) 200 J
Once ventricular fibrillation has been confirmed in a patient, which action is the priority?
a. ) Assessing vital signs
b. ) Opening the airway
c. ) Beginning rescue breathing
d. ) Starting chest compressions
d. ) Starting chest compressions
d.) Starting chest compressions
A patient becomes unresponsive without a palpable pulse despite showing bradycardia on the rhythm strip. What action should the nurse take immediately? (Select all that apply)
a. ) Auscultating heart sounds
b. ) Beginning cardiac compressions
c. ) Adjusting cardiac monitor leads
d. ) Obtaining blood samples for electrolytes
e. ) Placing epinephrine at the bedside
b. ) Beginning cardiac compressions
e. ) Placing epinephrine at the bedside
What is the order of electrical impulse through the heart?
1) SA node fires
2) Impulse spreads through the atrial myocardium
3) Impulse travels to the AV node
4) Impulse leaves the AV node through the bundle of His
5) Impulse travels through the bundle branches
6) Impulse extends into the ventricular tissue through the purkinje fibers
What are some major risk factors for cardiovascular disease?
Family history of cardiovascular disease
Diabetes mellitus
Chronic renal disease
Hypertension
Dyslipidemia
What are some examples of modifiable risk factors?
Weight
Dietary habits
Alcohol consumption
Smoking
The nurse is performing an assessment on a client and comes up with a blood pressure reading of 140/95. The client then states, “my blood pressure has been higher than that the last two times I have checked it”. Upon further evaluation, the nurse finds this to be true and knows that the client is experiencing what?
a) Stage 1 hypertension
b) Stage 2 hypertension
c) Nothing, this blood pressure reading is normal.
b) Stage 2 hypertension
What is the purpose of a transesophageal echocardiogram (TEE)?
This exam can allow doctors to get a clearer and better picture of the heart. This is most commonly used to see specific structures of the heart or to visualize clots in the heart chambers.
An older adult client is being evaluated for a new onset of a cardiac dysrhythmia. What should the nurse consider as being the cause for this abnormal heart rhythm? (Select all that apply)
a. ) Advanced age
b. ) Protein malnutrition
c. ) Fat deposits around the sinoatrial node
d. ) Fewer pacemaker cells in the sinoatrial node
e. ) Calcification around the atrioventricular node and valves
a. ) Advanced age
c. ) Fat deposits around the sinoatrial node
d. ) Fewer pacemaker cells in the sinoatrial node
e. ) Calcification around the atrioventricular node and valves
The nurse provides care to a patient who is prescribed IV adenosine. Which is the priority nursing action before administering the medication?
a. ) Monitoring respirations
b. ) Palpating the patient’s pulse
c. ) Teaching the patient to avoid caffeine intake
d. ) Ensuring a transcutaneous pacemaker is available
d.) Ensuring a transcutaneous pacemaker is available
In preparing a patient with atrial fibrillation for cardioversion, the nurse prepares the patient for which diagnostic test prior?
a. ) Chest x-ray
b. ) CT scan of the chest
c. ) 12-lead ECG
d. ) Transesophageal echocardiogram (TEE)
d.) Transesophageal echocardiogram (TEE)
A patient is being cardioverted for symptomatic atrial fibrillation. At which point of the cardiac cycle will the electric impulse occur?
a. ) At the end of the P wave
b. ) Before the QRS complex
c. ) At the peak of the R wave
d. ) After the QRS complex but before the T wave
c.) At the peak of the R wave
The nurse monitors for which clinical manifestation in the patient with atrial fibrillation at a heart rate of 90 beats per minute. Which manifestation should the nurse expect to assess in this patient?
a. ) Headache
b. ) Chest pain
c. ) Palpitations
d. ) Hypotension
c.) Palpitations
The nurse determines that demeclocycline (Declomycin) is effective for a patient with syndrome of inappropriate antidiuretic hormone (SIADH) based on finding that the patient’s
a. weight has increased.
b. urinary output is increased.
c. peripheral edema is decreased.
d. urine specific gravity is increased.
b. urinary output is increased.
Demeclocycline blocks the action of antidiuretic hormone (ADH) on the renal tubules and increases urine output. An increase in weight or an increase in urine specific gravity indicates that the SIADH is not corrected. Peripheral edema does not occur with SIADH. A sudden weight gain without edema is a common clinical manifestation of this disorder.
The nurse determines that additional instruction is needed for a 60-year-old patient with chronic syndrome of inappropriate antidiuretic hormone (SIADH) when the patient says which of the following?
a. “I need to shop for foods low in sodium and avoid adding salt to food.”
b. “I should weigh myself daily and report any sudden weight loss or gain.”
c. “I need to limit my fluid intake to no more than 1 quart of liquids a day.”
d. “I will eat foods high in potassium because diuretics cause potassium loss.”
a. “I need to shop for foods low in sodium and avoid adding salt to food.”
Patients with SIADH are at risk for hyponatremia, and a sodium supplement may be prescribed. The other patient statements are correct and indicate successful teaching has occurred
A 56-year-old patient who is disoriented and reports a headache and muscle cramps is hospitalized with possible syndrome of inappropriate antidiuretic hormone (SIADH). The nurse would expect the initial laboratory results to include a(n)
a. elevated hematocrit.
b. decreased serum sodium.
c. low urine specific gravity.
d. increased serum chloride.
b. decreased serum sodium.
When water is retained, the serum sodium level will drop below normal, causing the clinical manifestations reported by the patient. The hematocrit will decrease because of the dilution caused by water retention. Urine will be more concentrated with a higher specific gravity. The serum chloride level will usually decrease along with the sodium level.
Which intervention will the nurse include in the plan of care for a 52-year-old male patient with syndrome of inappropriate antidiuretic hormone (SIADH)?
a. Monitor for peripheral edema.
b. Offer patient hard candies to suck on.
c. Encourage fluids to 2 to 3 liters per day.
d. Keep head of bed elevated to 30 degrees.
b. Offer patient hard candies to suck on.
Sucking on hard candies decreases thirst for a patient on fluid restriction. Patients with SIADH are on fluid restrictions of 800 to 1000 mL/day. Peripheral edema is not seen with SIADH. The head of the bed is elevated no more than 10 degrees to increase left atrial filling pressure and decrease antidiuretic hormone (ADH) release.
Which information is most important for the nurse to communicate rapidly to the health care provider about a patient admitted with possible syndrome of inappropriate antidiuretic hormone (SIADH)?
a. The patient has a recent weight gain of 9 lb.
b. The patient complains of dyspnea with activity.
c. The patient has a urine specific gravity of 1.025.
d. The patient has a serum sodium level of 118 mEq/L.
d. The patient has a serum sodium level of 118 mEq/L.
A serum sodium of less than 120 mEq/L increases the risk for complications such as seizures and needs rapid correction. The other data are not unusual for a patient with SIADH and do not indicate the need for rapid action
Which action should the nurse take when administering the initial dose of oral labetalol (Normodyne) to a patient with hypertension?
a. Encourage the use of hard candy to prevent dry mouth.
b. Instruct the patient to ask for help if heart palpitations occur.
c. Ask the patient to request assistance when getting out of bed.
d. Teach the patient that headaches may occur with this medication.
c. Ask the patient to request assistance when getting out of bed.
After the nurse teaches the patient with stage 1 hypertension about diet modifications that should be implemented, which diet choice indicates that the teaching has been effective?
a. The patient avoids eating nuts or nut butters.
b. The patient restricts intake of chicken and fish.
c. The patient has two cups of coffee in the morning.
d. The patient has a glass of low-fat milk with each meal.
d. The patient has a glass of low-fat milk with each meal.
An older patient has been diagnosed with possible white coat hypertension. Which action will the nurse plan to take next?
a. Schedule the patient for regular blood pressure (BP) checks in the clinic.
b. Instruct the patient about the need to decrease stress levels.
c. Tell the patient how to self-monitor and record BPs at home.
d. Inform the patient that ambulatory blood pressure monitoring will be needed.
c. Tell the patient how to self-monitor and record BPs at home.
The nurse is reviewing the laboratory test results for a patient who has recently been diagnosed with hypertension. Which result is most important to communicate to the health care provider?
a. Serum creatinine of 2.8 mg/dL
b. Serum potassium of 4.5 mEq/L
c. Serum hemoglobin of 14.7 g/dL
d. Blood glucose level of 96 mg/dL
a. Serum creatinine of 2.8 mg/dL
A patient with a history of hypertension treated with a diuretic and an angiotensin-converting enzyme (ACE) inhibitor arrives in the emergency department complaining of a severe headache and nausea and has a blood pressure (BP) of 238/118 mm Hg. Which question should the nurse ask first?
a. “Did you take any acetaminophen (Tylenol) today?”
b. “Have you been consistently taking your medications?”
c. “Have there been any recent stressful events in your life?”
d. “Have you recently taken any antihistamine medications?”
b. “Have you been consistently taking your medications?”
When reviewing the 12-lead electrocardiograph (ECG) for a healthy 86-year-old patient who is having an annual physical examination, which of the following will be of most concern to the nurse?
a. The heart rate (HR) is 43 beats/minute.
b. The PR interval is 0.21 seconds.
c. There is a right bundle-branch block.
d. The QRS duration is 0.13 seconds
a. The heart rate (HR) is 43 beats/minute.
A patient is scheduled for a cardiac catheterization with coronary angiography. Before the test, the nurse informs the patient that
a. electrocardiographic (ECG) monitoring will be required for 24 hours after the test.
b. it will be important to lie completely still during the procedure.
c. a warm feeling may be noted when the contrast dye is injected.
d. monitored anesthesia care will be provided during the procedure.
c. a warm feeling may be noted when the contrast dye is injected.
The nurse expects that management of the patient who experiences a brief episode of tinnitus, diplopia, and dysarthria with no residual effects will include
a. prophylactic clipping of cerebral aneurysms.
b. heparin via continuous intravenous infusion.
c. oral administration of low dose aspirin therapy.
d. therapy with tissue plasminogen activator (tPA).
c. oral administration of low dose aspirin therapy.
The nurse identifies the nursing diagnosis of impaired verbal communication for a patient with expressive aphasia. An appropriate nursing intervention to help the patient communicate is to
a. have the patient practice facial and tongue exercises.
b. ask simple questions that the patient can answer with “yes” or “no.”
c. develop a list of words that the patient can read and practice reciting.
d. prevent embarrassing the patient by changing the subject if the patient does not respond.
b. ask simple questions that the patient can answer with “yes” or “no.”
A patient has a stroke affecting the right hemisphere of the brain. Based on knowledge of the effects of right brain damage, the nurse establishes a nursing diagnosis of
a. impaired physical mobility related to right hemiplegia.
b. risk for injury related to denial of deficits and impulsiveness.
c. impaired verbal communication related to speech-language deficits.
d. ineffective coping related to depression and distress about disability.
b. risk for injury related to denial of deficits and impulsiveness.
When caring for a patient with left-sided homonymous hemianopsia resulting from a stroke, which intervention should the nurse include in the plan of care during the acute period of the stroke?
a. Apply an eye patch to the left eye.
b. Approach the patient from the left side.
c. Place objects needed for activities of daily living on the patient’s right side.
d. Reassure the patient that the visual deficit will resolve as the stroke progresses.
c. Place objects needed for activities of daily living on the patient’s right side.
The nurse identifies the nursing diagnosis of imbalanced nutrition: less than body requirements related to impaired self-feeding ability for a patient with right-sided hemiplegia. Which intervention should be included in the plan of care?
a. Provide a wide variety of food choices.
b. Provide oral care before and after meals.
c. Assist the patient to eat with the left hand.
d. Teach the patient the “chin-tuck” technique.
c. Assist the patient to eat with the left hand.
A 32-year-old patient has a stroke resulting from a ruptured aneurysm and subarachnoid hemorrhage. Which intervention will be included in the care plan?
a. Applying intermittent pneumatic compression stockings
b. Assisting to dangle on edge of bed and assess for dizziness
c. Encouraging patient to cough and deep breathe every 4 hours
d. Inserting an oropharyngeal airway to prevent airway obstruction
a. Applying intermittent pneumatic compression stockings
Several weeks after a stroke, a patient has urinary incontinence resulting from an impaired awareness of bladder fullness. For an effective bladder training program, which nursing intervention will be best to include in the plan of care?
a. Limit fluid intake to 1200 mL daily to reduce urine volume.
b. Assist the patient onto the bedside commode every 2 hours.
c. Perform intermittent catheterization after each voiding to check for residual urine.
d. Use an external “condom” catheter to protect the skin and prevent embarrassment.
b. Assist the patient onto the bedside commode every 2 hours.
A patient with chronic atrial fibrillation develops sudden severe pain, pulselessness, pallor, and coolness in the left leg. The nurse should notify the health care provider and
a. elevate the left leg on a pillow.
b. apply an elastic wrap to the leg.
c. assist the patient in gently exercising the leg.
d. keep the patient in bed in the supine position
d. keep the patient in bed in the supine position
A patient at the clinic says, “I have always taken an evening walk, but lately my leg cramps and hurts after just a few minutes of walking. The pain goes away after I stop walking, though.” The nurse should
a. attempt to palpate the dorsalis pedis and posterior tibial pulses.
b. check for the presence of tortuous veins bilaterally on the legs.
c. ask about any skin color changes that occur in response to cold.
d. assess for unilateral swelling, redness, and tenderness of either leg.
a. attempt to palpate the dorsalis pedis and posterior tibial pulses.
The nurse has initiated discharge teaching for a patient who is to be maintained on warfarin (Coumadin) following hospitalization for venous thromboembolism (VTE). The nurse determines that additional teaching is needed when the patient says,
a. “I should reduce the amount of green, leafy vegetables that I eat.”
b. “I should wear a Medic Alert bracelet stating that I take Coumadin.”
c. “I will need to have blood tests routinely to monitor the effects of the Coumadin.”
d. “I will check with my health care provider before I begin or stop any medication.”
a. “I should reduce the amount of green, leafy vegetables that I eat.”
What is depolarization?
What is repolarization?
Depolarization - Contraction of the heart
Repolarization - Resting state of the heart
A 62-year old man with chronic anemia is experiencing increased fatigue and occasional palpitations at rest. The nurse would expect the patient’s laboratory findings to include
a. a hematocrit (Hct) of 38%.
b. an RBC count of 4,500,000/μL.
c. normal red blood cell (RBC) indices.
d. a hemoglobin (Hgb) of 8.6 g/dL (86 g/L)
d. a hemoglobin (Hgb) of 8.6 g/dL (86 g/L)
A patient who is receiving methotrexate for severe rheumatoid arthritis develops a megaloblastic anemia. The nurse will anticipate teaching the patient about increasing oral intake of
a. iron.
b. folic acid.
c. cobalamin (vitamin B12).
d. ascorbic acid (vitamin C).
b. folic acid.
On admission of a patient to the postanesthesia care unit (PACU), the blood pressure (BP) is 122/72. Thirty minutes after admission, the BP falls to 114/62, with a pulse of 74 and warm, dry skin. Which action by the nurse is most appropriate?
a. Increase the IV fluid rate.
b. Continue to take vital signs every 15 minutes.
c. Administer oxygen therapy at 100% per mask.
d. Notify the anesthesia care provider (ACP) immediately.
b. Continue to take vital signs every 15 minutes.
The nurse describes to a student nurse how to use evidencebased practice guidelines when caring for patients. Which statement, if made by the nurse, would be the most accurate?
a. “Inferences from clinical research studies are used as a guide.”
b. “Patient care is based on clinical judgment, experience, and traditions.”
c. “Data are evaluated to show that the patient outcomes are consistently met.”
d. “Recommendations are based on research, clinical expertise, and patient preferences.”
d. “Recommendations are based on research, clinical expertise, and patient preferences.”
A nurse is caring for a patient with heart failure. Which task is appropriate for the nurse to delegate to experienced unlicensed assistive personnel (UAP)?
a. Monitor for shortness of breath or fatigue after ambulation.
b. Instruct the patient about the need to alternate activity and rest.
c. Obtain the patient’s blood pressure and pulse rate after ambulation.
d. Determine whether the patient is ready to increase the activity level.
c. Obtain the patient’s blood pressure and pulse rate after ambulation.
A patient with newly diagnosed type 2 diabetes mellitus asks the nurse what ““type 2”” means in relation to diabetes. The nurse explains to the patient that type 2 diabetes differs from type 1 diabetes primarily in that with type 2 diabetes
a. the pt is totally dependent on an outside source of insulin
b. there is a decreased insulin secretion and cellular resistance to insulin that is produced
c. the immune system destroys the pancreatic insulin-producing cells
d. the insulin precurosr that is secreted by the pancreas is not activated by the liver
b. there is a decreased insulin secretion and cellular resistance to insulin that is produced
In type 2 diabetes, the pancreas produces insulin, but the insulin is insufficient for the body’s needs or the cells do not respond to the insulin appropriately. The other information describes the physiology of type 1 diabetes
The benefits of using an insulin pump include all of the following except: “
a. By continuously providing insulin they eliminate the need for injections of insulin
b. They simplify management of blood sugar and often improve A1C
c. They enable exercise without compensatory carbohydrate consumption
d. They help with weight loss
d. They help with weight loss
Using an insulin pump has many advantages, including fewer dramatic swings in blood glucose levels, increased flexibility about diet, and improved accuracy of insulin doses and delivery; however, the use of an insulin pump has been associated with weight gain.
A 54-year-old patient admitted with type 2 diabetes, asks the nurse what “type 2” means. Which of the following is the most appropriate response by the nurse?
“1. ““With type 2 diabetes, the body of the pancreas becomes inflamed.”
- “With type 2 diabetes, insulin secretion is decreased and insulin resistance is increased.”
- “With type 2 diabetes, the patient is totally dependent on an outside source of insulin.”
- “With type 2 diabetes, the body produces autoantibodies that destroy b-cells in the pancreas.””
- “With type 2 diabetes, insulin secretion is decreased and insulin resistance is increased.”
Rationale: In type 2 diabetes mellitus, the secretion of insulin by the pancreas is reduced and/or the cells of the body become resistant to insulin”
“A client is admitted to the hospital with signs and symptoms of diabetes mellitus. Which findings is the nurse most likely to observe in this client? Select all that apply:
- Excessive thirst
- Weight gain
- Constipation
- Excessive hunger
- Urine retention
- Frequent, high-volume urination
- Excessive thirst
- Excessive hunger
- Frequent, high-volume urination
Rationale: Classic signs of diabetes mellitus include polydipsia (excessive thirst), polyphagia (excessive hunger), and polyuria (excessive urination). Because the body is starving from the lack of glucose the cells are using for energy, the client has weight loss, not weight gain. Clients with diabetes mellitus usually don’t present with constipation. Urine retention is only a problem is the patient has another renal-related condition.
A client is brought to the emergency department in an unresponsive state, and a diagnosis of hyperglycemic hyperosmolar nonketotic syndrome is made. The nurse would immediately prepare to initiate which of the following anticipated physician’s prescriptions?
- Endotracheal intubation
- 100 units of NPH insulin
- Intravenous infusion of normal saline
- Intravenous infusion of sodium bicarbonate
- Intravenous infusion of normal saline
Intravenous infusion of normal saline Rationale: The primary goal of treatment is hyperglycemic hyperosmolar nonketotic syndrome (HHNS) is to rehydrate the client to restore the fluid volume and to correct electrolyte deficiency. Intravenous fluid replacement is similar to that administered in diabetic keto acidosis (DKA) and begins with IV infusion of normal saline. Regular insulin, not NPH insulin, would be administered. The use of sodium bicarbonate to correct acidosis is avoided because it can precipitate a further drop in serum potassium levels. Intubation and mechanical ventilation are not required to treat HHNS.
“A client is taking Humulin NPH insulin daily every morning. The nurse instructs the client that the mostlikely time for a hypoglycemic reaction to occur is:
A) 2-4 hours after administration
B) 4-12 hours after administration
C) 16-18 hours after administration
D) 18-24 hours after administration
B) 4-12 hours after administration
Rationale: Humulin is an intermediate acting insulin. The onset of action is 1.5 hours, it peaks in 4-12 hours, and its duration is 24 hours. Hypoglycemic reactions to insulin are most likely to occur during the peak time.
“A client who is started on metformin and glyburide would have initially presented with which symptoms? “
a. Polydispisa, polyuria, and weight loss
b. weight gain, tiredness, & bradycardia
c. irritability, diaphoresis, and tachycardia
d. diarrhea, abdominal pain, and weight loss
a. Polydispisa, polyuria, and weight loss
Symptoms of hyperglycemia include polydipsia, polyuria, and weight loss. Metformin and sulfonylureas are commonly ordered medications. Weight gain, tiredness, and bradycardia are symptoms of hypothyroidism. Irritability, diaphoresis, and tachycardia are symptoms of hypoglycemia. Symptoms of Crohn’s disease include diarrhea, abdominal pain, and weight loss.”
A client with diabetes mellitus demonstratees acute anxiety when first admitted for the treatment of hyperglycemia. The most appropriate intervention to decrease the client’s anxiety would be to
- administer a sedative
- make sure the client knows all the correct medical terms to understand what is happening
- ignore the signs and symptoms of anxiety so that they will soon disappear
- convey empathy, trust, and respect toward the client
- convey empathy, trust, and respect toward the client
The most appropriate intervention is to address the client’s feelings related to the anxiety
A client with diabetes melllitus has a blood glucose of 644mg/dl. The nurse intreprets that this client is most at risk of developing which type of acid base imbalance? “
A. Metabolic acidosis
B. Metabolic alkalosis
C. Respiratory Acidosis
D. Respiratory Alkalosis”
A. Metabolic acidosis
Rationale: DM can lead to metabolic acidosis. When the body does not have sufficient circulating insulin, the blood glucose level rises. At the same time, the cells of the body use all available glucose. The body then breaks down glycogen and fat for fuel. The by-products of fat metabolism are acidotic and can lead to the condition known as diabetic ketoacidosis.”
A client with DKA is being treated in the ED. What would the nurse suspect?
- Comatose state
- Decreased Urine Output
- Increased respirations and an increase in pH.
- Elevated blood glucose level and low plasma bicarbonate level.
- Elevated blood glucose level and low plasma bicarbonate level.
Rationale: In DKA the arteriole pH is lower than 7.35, plasma bicarbonate is lower than 15 mEq/L, the blood glucose is higher than 250, and ketones are present in the blood and urine. The client would be experiencing polyuria and Kussmauls respirations would be present. A comatose state may occur if DKA is not treated.
A client with type I diabetes is placed on an insulin pump. The most appropriate short-term goal when teaching this client to control the diabetes is: “
1) adhere to the medical regimen
2) remain normoglycemic for 3 weeks
3) demonstrate the correct use of the administration equipment.
4) list 3 self care activities that are necessary to control the diabetes”
CORRECT 3) demonstrate the correct use of the administration equipment.
1) this is not a short-term goal
2) this is measurable, but it’s a long-term goal
3) this is a short-term goal, client oriented, necessary for the client to control the diabetes, and measurable when the client performs a return demonstration for the nurse
4) although this is measurable and a short-term goal, it is not the one with the greatest priority when a client has an insulin pump that must be mastered before discharge”
A diabetic patient has a serum glucose level of 824 mg/dL (45.7 mmol/L) and is unresponsive. Following assessment of the patient, the nurse suspects diabetic ketoacidosis rather than hyperosmolar hyperglycemic syndrome based on the finding of “
a. polyuria
b. severe dehydration
c. rapid, deep respirations
d. decreased serum potassium”
c. rapid, deep respirations
is correct, Signs and symptoms of DKA include manifestations of dehydration such as poor skin turgor, dry mucous membranes, tachycardia, and orthostatic hypotension. Early symptoms may include lethargy and weakness. As the patient becomes severely dehydrated, the skin becomes dry and loose, and the eyeballs become soft and sunken. Abdominal pain is another symptom of DKA that may be accompanied by anorexia and vomiting. Kussmaul respirations (i.e., rapid, deep breathing associated with dyspnea) are the body’s attempt to reverse metabolic acidosis through the exhalation of excess carbon dioxide. Acetone is identified on the breath as a sweet, fruity odor. Laboratory findings include a blood glucose level greater than 250 mg/dL, arterial blood pH less than 7.30, serum bicarbonate level less than 15 mEq/L, and moderate to large ketone levels in the urine or blood ketones.
A frail elderly patient with a diagnosis of type 2 diabetes mellitus has been ill with pneumonia. The cliet’s intake has been very poor, and she is admitted to the hospital for observation and management as needed. What is the most likely problem with this patient? “
A. Insulin resistance has developed.
B. Diabetic ketoacidosis is occuring.
C. Hypoglycemia unawareness is developing.
D. Hyperglycemic hyperosmolar non-ketotic coma.
D. Hyperglycemic hyperosmolar non-ketotic coma.
Illness, especially with the frail elderly patient whose appetite is poor, can result in dehydration and HHNC. Insulin resisitance is inidcated by a daily insulin requirement of 200 units or more. Diabetic ketoacidosis, an acute metabolic condition, usually is caused by absent or markedly decreased amounts of insulin.
A home health nurse is at the home of a client with diabetes and arthritis. The client has difficulty drawing up insulin. It would be most appropriate for the nurse to refer the client to: “
A) A social worker from the local hospital
B) An occupational therapist from the community center
C) A physical therapist from the rehabilitation agency
D) Another client with diabetes mellitus and takes insulin”
B) An occupational therapist from the community center
An occupational therapist can assist a client to improve the fine motor skills needed to prepare an insulin injection.
A nurse is caring for a cient with type 1 diabetes mellitus. which client complaint would alert the nurse to the presence of a possible hypoglycemic reaction? “
- Tremors
- Anorexia
- Hot, dry skin
- Muscle cramps
- Tremors
decreased blood glucose levels produce autonomic nervous system symptoms, which are manifested classically as nervousness, irritability, and tremors. option 3 is more likely for hyperglycemia, and options 2 and 4 are unrelated to the signs of hypoglycemia.
A nurse is caring for a client admitted to the emergency department with diabetic ketoacidosis (DKA). In the acute phase, the priority nursing action is to prepare to:
A. Correct the acidosis
B. Administer 5% dextrose intravenously
C. Administer regular insulin inraVenously
D. Apply a monitor for an electrocardiogram.
C. Administer regular insulin inraVenously
Lack (absolute or relative) of insulin is the primary cause of DKA. Treatment consists of insulin administration (regular insulin), intravenous fluid administration (normal saline initially), and potassium replacement, followed by correcting acidosis. Applying an electrocardiogram monitor is not a priority action.
a nurse is interviewing a client with type 2 diabetes mellitus. which statement by the client indicated an understanding of the treatment for this disorder? “
- "”i take oral insulin instead of shots””
- "”by taking these medications I am able to eat more””
- "”when I become ill, I need to increase the number of pills I take””
- "”the medications I’m taking help release the insulin I already make”
- “the medications I’m taking help release the insulin I already make”
Clients with type 2 diabetes mellitus have decreased or imparied insulin secretion. Oral hypoglycemic agents are given to these clients to facilitate glucose uptake. Insulin injections may be given during times of stress-induced hyperglycemia. Oral insulin is not available because of the breakdown of the insulin by digestion. Options 1, 2 and 3 are incorrect
A nurse is preparing a teaching plan for a client with diabetes Mellitus regarding proper foot care. Which instruction is included in the plan?
- Soak feet in hot water
- apply a moisturizing lotion to dry feet but not between the toes
- Always have a podiatrist cut your toenails, never cut them yourself
- avoid using mild soap on the feet
- apply a moisturizing lotion to dry feet but not between the toes
The client is instructed to use a moisturizing lotion on the feet and to avoid applying the lotion between the toes.
A nurse performs a physical assessment on a client with type 2 diabetes mellitus. Findings include a fasting blood glucose of 120 mg/dL, temp of 101 F, pulse of 88 bpm, respirations of 22, and blood pressure of 100/72. Which finding would be of most concern to the nurse?
- Pulse
- Respiration
- Temperature
- Blood pressure
- Temperature
An elevated temperature may indicate infection. Infection is a leading cause of hyperglycemic hyperosmolar nonketotic syndrome or diabetic ketoacidosis. The other findings noted in the question are within normal limits.
A nurse shoud recognize which symptom as a cardinal sign of diabetes mellitus? “
a. Nausea
b. Seizure
c. Hyperactivity
d. Frequent urination
d. Frequent urination
Polyphagia, polyuria, polydipsia, and weight loss are cardinal signs of DM. Other signs include irritability, shortened attention span, lowered frustration tolerance, fatigue, dry skin, blurred vision, sores that are slow to heal, and flushed skin.
A patient is admitted with diabetes mellitus, has a glucose level of 380 mg/dl, and a moderate level of ketones in the urine. As the nurse assesses for signs of ketoacidosis, which of the following respiratory patterns would the nurse expect to find?”
A-Central apnea
B-Hypoventilation
C-Kussmaul respirations
D- Cheyne-Stokes respirations”
C-Kussmaul respirations
In diabetic ketoacidosis, the lungs try to compensate for the acidosis by blowing off volatile acids and carbon dioxide. This leads to a pattern of Kussmaul respirations, which are deep and nonlabored.
“A patient with type 1 diabetes has received diet instruction as part of the treatment plan. The nurse determines a need for additional instruction when the patient says, “
a. ““I may have an occasional alcoholic drink if I include it in my meal plan.””
b. ““I will need a bedtime snack because I take an evening dose of NPH insulin.””
c. ““I will eat meals as scheduled, even if I am not hungry, to prevent hypoglycemia.””
d. ““I may eat whatever I want, as long as I use enough insulin to cover the calories.
D. ““I may eat whatever I want, as long as I use enough insulin to cover the calories.””
Rationale: Most patients with type 1 diabetes need to plan diet choices very carefully. Patients who are using intensified insulin therapy have considerable flexibility in diet choices but still should restrict dietary intake of items such as fat, protein, and alcohol. The other patient statements are correct and indicate good understanding of the diet instruction.”
“An 18-year-old female client, 5’4’’ tall, weighing 113 kg, comes to the clinic for a non-healing wound on her lower leg, which she has had for two weeks. Which disease process should the nurse suspect the client is developing? “
A. Type 1 diabetes
B. Type 2 diabetes
C. Gestational diabetes
D. Acanthosis nigrican
B. Type 2 diabetes
is a disorder usually occurring around the age of 40, but it is now being detected in children and young adults as a result of obesity and sedentary lifestyles. Non-healing wounds are a hallmark sign of type 2 diabetes. This client weights 248.6 lbs and is short.
An adolescent client with type I diabetes mellitus is admitted to the emergency department for treatment of diabetic ketoacidosis. Which assessment findings should the nurse expect to note? “
a) sweating and tremors
b) hunger and hypertension
c) cold, clammy skin and irritability
d) fruity breath and decreasing level of consciousness
d) fruity breath and decreasing level of consciousness
“Hyperglycemia occurs with diabetic ketoacidosis. Signs of hyperglycemia include fruity breath and a decreasing level of consciousness. Hunger can be a sign of hypoglycemia or hyperglycemia, but hypertension is not a sign of diabetic ketoacidosis. Instead, hypotension occurs because of a decrease in blood volume related to the dehydrated state that occurs during diabetic ketoacidosis. Cold, clammy skin, irritability, sweating, and tremors are all signs of hypoglycemia.”
An external insulin pump is prescribed for a client with DM. The client asks the nurse about the functioning of the pump. The nurse bases the response on the information that the pump: “
a. Gives small continuous dose of regular insulin subcutaneously, and the client can self-administer a bolus with an additional dosage from the pump before each meal.
b. Is timed to release programmed doses of regular or NPH insulin into the bloodstream at specific intervals.
c. Is surgically attached to the pancreas and infuses regular insulin into the pancreas, which in turn releases the insulin into the bloodstream.
d. Continuously infuses small amounts of NPH insulin into the bloodstream while regularly monitoring blood glucose levels”
a. Gives small continuous dose of regular insulin subcutaneously, and the client can self-administer a bolus with an additional dosage from the pump before each meal.
An insulin pump provides a small continuous dose of regular insulin subcutaneously throughout the day and night, and the client can self-administer a bolus with additional dosage from the pump before each meal as needed. Regular insulin is used in an insulin pump. An external pump is not attached surgically to the pancreas.
Analyze the following diagnostic findings for your patient with type 2 diabetes. Which result will need further assessment?
A) BP 126/80
B) A1C 9%
C)FBG 130mg/dL
D) LDL cholesterol 100mg/dL
“B) A1C 9%
Rationale: Lowering hemoglobin A1C (to average of 7%) reduces microvascular and neuropathic complications. Tighter glycemic control(normal A1C < 6%) may further reduce complications but increases hypoglycemia risk.”
Blood sugar is well controlled when Hemoglobin A1C is… “
a. Below 7%
b. Between 12%-15%
c. Less than 180 mg/dL
d. Between 90 and 130 mg/dL”
a. Below 7%
A1c measures the percentage of hemoglobin that is glycated and determines average blood glucose during the 2 to 3 months prior to testing. Used as a diagnostic tool, A1C levels of 6.5% or higher on two tests indicate diabetes. A1C of 6% to 6.5% is considered prediabetes.”
Excessive thirst and volume of very dilute urine may be symptoms of: “
A. Urinary tract infection
B. Diabetes insipidus
C. Viral gastroenteritis
D.Hypoglycemia”
B. Diabetes insipidus
Diabetes insipidus is a condition in which the kidneys are unable to conserve water, often because there is insufficient antidiuretic hormone (ADH) or the kidneys are unable to respond to ADH. Although diabetes mellitus may present with similar symptoms, the disorders are different. Diabetes insipidus does not involve hyperglycemia.”
In educating a client with diabetes, what response would reveal need for further education? “
A. I should avoid tights
B. I should take good care of my toe nails
C. I should not go more than 3 days without washing my feet
D. I should avoid going barefoot and should wear clean socks
C. I should not go more than 3 days without washing my feet
“The recommended self-care routine is to wash feet on a daily basis without soaking and carefully cleaning.”
Of which of the following symptoms might an older woman with diabetes mellitus complain?
1) anorexia
2) pain intolerance
3) weight loss
4) perineal itching
4) perineal itching
Rationale: Older women might complain of perineal itching due to vaginal candidiasis.
One of the benefits of Glargine (Lantus) insulin is its ability to:
a. Release insulin rapidly throughout the day to help control basal glucose.
b. Release insulin evenly throughout the day and control basal glucose levels.
c. Simplify the dosing and better control blood glucose levels during the day.
d. Cause hypoglycemia with other manifestation of other adverse reactions.
B)Release insulin evenly throughout the day and control basal glucose levels
“Glargine (Lantus) insulin is designed to release insulin evenly throughout the day and control basal glucose levels
Prediabetes is associated with all of the following except: “
a. Increased risk of developing type 2 diabetes
b. Impaired glucose tolerance
c. Increased risk of heart disease and stroke
d. Increased risk of developing type 1 diabetes”
d. Increased risk of developing type 1 diabetes
Persons with elevated glucose levels that do not yet meet the criteria for diabetes are considered to have prediabetes and are at increased risk of developing type 2 diabetes. Weight loss and increasing physical activity can help people with prediabetes prevent or postpone the onset of type 2 diabetes.”
Risk factors for type 2 diabetes include all of the following except:
a. Advanced age
b. Obesity
c. Smoking
d. Physical inactivity”
c. Smoking
“Additional risk factors for type 2 diabetes are a family history of diabetes, impaired glucose metabolism, history of gestational diabetes, and race/ethnicity. African-Americans, Hispanics/Latinos, Asian Americans, Native Hawaiians, Pacific Islanders, and Native Americans are at greater risk of developing diabetes than whites.”
The client diagnosed with Type I diabetes is found lying unconscious on the floor of the bathroom. Which interventions should the nurse implement first?
A. Administer 50% dextrose IVP.
B. Notify the health-care provider.
C. Move the client to ICD.
D. Check the serum glucose level
A. Administer 50% dextrose IVP.
The nurse should assume the client is hypoglycemic and administer IVP dextrose, which will rouse the client immediately. If the collapse is the result of hyperglycemia, this additional dextrose will not further injure the client.
The client, an 18-year-old female, 5’4’’ tall, weighing 113 kg, comes to the clinic for a wound on her lower leg that has not healed for the last two (2) weeks. Which diseaseprocess would the nurse suspect that the client has developed? “
- Type 1 diabetes.
- Type 2 diabetes.
- Gestational diabetes.
- Acanthosis nigricans
2.Type 2 diabetes.
Type 2 diabetes is a disorder that usually occurs around the age of 40, but it is now being detected in children and young adultsas a result of obesity and sedentary life-styles. Wounds that do not heal are a hall-mark sign of Type 2 diabetes. This client weighs 248.6 pounds and is short”
The guidelines for Carbohydrate Counting as medical nutrition therapy for diabetes mellitus includes all of the following EXCEPT:
a. Flexibility in types and amounts of foods consumed
b. Unlimited intake of total fat, saturated fat and cholesterol
c. Including adequate servings of fruits, vegetables and the dairy group
d. Applicable to with either Type 1 or Type 2 diabetes mellitusb. Unlimited intake of total fat, saturated fat and cholesterol”
b. Unlimited intake of total fat, saturated fat and cholesterol
You want to be careful of how much you eat in any food group
The nurse administered 28 units of Humulin N, an intermediate-acting insulin, to a client diagnosed with Type 1 diabetes at 1600. Which action should the nurse implement? “
- Ensure the client eats the bedtime snack.
- Determine how much food the client ate at lunch.
- Perform a glucometer reading at 0700.
- Offer the client protein after administering insulin.
- Ensure the client eats the bedtime snack.
Humulin N peaks in 6-8 hours, making the client at risk for hypoglycemia around midnight, which is why the client should receive a bedtime snack. This snack will prevent nighttime hypoglycemia. (Correct)
The nurse assisting in the admission of a client with diabetic ketoacidosis will anticipate the physician ordering which of the following types of intravenous solution if the client cannot take any fluids orally? “
a. 0.45% normal saline solution
b. Lactated Ringer’s solution
c. 0.9 normal saline solution
d. 5% dextrose in water (D5W)”
a. 0.45% normal saline solution
normal saline solution Helps to hydrate patient and keep electrolyte levels balanced
The nurse caring for a 54-year-old patient hospitalized with diabetes mellitus would look for which of the following laboratory test results to obtain information on the patient’s past glucose control?
a. prealbumin level
b. urine ketone level
c. fasting glucose level
d. glycosylated hemoglobin level
d. glycosylated hemoglobin level
A glycosylated hemoglobin level detects the amount of glucose that is bound to red blood cells (RBCs). When circulating glucose levels are high, glucose attaches to the RBCs and remains there for the life of the blood cell, which is approximately 120 days. Thus the test can give an indication of glycemic control over approximately 2 to 3 months.
EKG (1,2)
EKG (3)
Another EKG interpretation :)
The nurse is caring for a client who has normal glucose levels at bedtime, hypoglycemia at 2am and hyperglycemia in the morning. What is this client likely experiencing? “
A. Dawn phenomenon
B. Somogyi effect
C. An insulin spike
D. Excessive corticosteroids”
B. Somogyi effect
The Somogyi effect is when blood sugar drops too low in the morning causing rebound hyperglycemia in the morning. The hypoglycemia at 2am is highly indicative. The Dawn phenomenon is similar but would not have the hypoglycemia at 2am.”
The nurse is caring for a client with long-term Type 2 diabetes and is assessing the feet. Which assessment data would warrant immediate intervention by the nurse? “
1) The client has crumbling toenails
2) The client has athlete’s feet
3) The client has a necrotic big toe
4) The client has thickened toenails.”
3)The client has a necrotic big toe
Crumbling toenails indicate tinea unguium, which is a fungus infection of the toenail. 2)Athlete’s foot is a fungal infection that is not life threatening. 3)A necrotic big toe indicates “dead” tissue. The client does not feel pain in the lower extremity and does not realize there has been an injury and therefore does not seek treatment. Increased blood glucose levels decrease oxygen supply that is needed to heal the wound and increase the risk for developing an infection. 4)Big, thick toenails are fungal infections and would not require immediate intervention by the nurse; 50% of the adult population has this.”]
The nurse is caring for a patient whose blood glucose level is 55mg/dL. What is the likely nursing response? “
A. Administer a glucagon injection
B. Give a small meal
C. Administer 10-15 g of a carbohydrate
D. Give a small snack of high protein food
C. Administer 10-15 g of a carbohydrate
The client has low hypoglycemia. This is generally treated with a small snack.”
The nurse is caring for a woman at 37 weeks gestation. The client was diagnosed with insulin-dependent diabetes mellitis (IDDM) at age 7. The client states, ““I am so thrilled that I will be breastfeeding my baby.”” Which of the following responses by the nurse is best? “
- You will probably need less insulin while you are breastfeeding.
- You will need to initially increase your insulin after the baby is born.
- You will be able to take an oral hypoglycemic instead of insulin after the baby is born.
- You will probably require the same dose of insulin that you are now taking.
- You will probably need less insulin while you are breastfeeding.
- breastfeeding has an antidiabetogenic effect, less insulin is needed. (correct) 2. insulin needs will decrease due to antidiabetogenic effect of breastfeeding and physiological changes during immediate postpartum period. 3. client has IDDM, insulin required. 4. during third trimester insulin requirements increase due to increased insulin resistance”
The nurse is discharging a client diagnosed with diabetes insipidus. Which statementmade by the client warrants further intervention? “
- “I will keep a list of my medications in my wallet and wear a Medi bracelet.”
- “I should take my medication in the morning and leave it refrigerated at home.”
- “I should weigh myself every morning and record any weight gain.”
- “If I develop a tightness in my chest, I will call my health-care provider.”
2.”I should take my medication in the morning and leave it refrigerated at home.”
I should take my medication in the morning and leave it refrigerated at home.”“1.The client should keep a list of medication being taken and wear a Medic Alert bracelet. 2. Medication taken for DI is usually every 8-12 hours, depending on the client. Theclient should keep the medication close at hand. 3.The client is at risk for fluid shifts. Weighing every morning allows the client to follow thefluid shifts. Weight gain could indicate too much medication. 4.Tightness in the chest could be an indicator that the medication is not being tolerated; if this occurs the client should call the health-care provider”
The nurse is discussing the importance of exercising to a client diagnosed with Type 2diabetes whose diabetes is well controlled with diet and exercise. Which informationshould the nurse include in the teaching about diabetes? “
- Eat a simple carbohydrate snack before exercising.
- Carry peanut butter crackers when exercising.
- Encourage the client to walk 20 minutes three (3) times a week.
- Perform warmup and cooldown exercises
4.Perform warmup and cooldown exercises
All clients who exercise should perform warmup and cooldown exercises to helpprevent muscle strain and injury”
The nurse is educating a pregnant client who has gestational diabetes. Which of the following statements should the nurse make to the client? Select all that apply. “
a. Cakes, candies, cookies, and regular soft drinks should be avoided.
b. Gestational diabetes increases the risk that the mother will develop diabetes later in life.
c. Gestational diabetes usually resolves after the baby is born.
d. Insulin injections may be necessary.
e. The baby will likely be born with diabetes f. The mother should strive to gain no more weight during the pregnancy.
a. Cakes, candies, cookies, and regular soft drinks should be avoided.
b. Gestational diabetes increases the risk that the mother will develop diabetes later in life.
c. Gestational diabetes usually resolves after the baby is born.
d. Insulin injections may be necessary.
Gestational diabetes can occur between the 16th and 28th week of pregnancy. If not responsive to diet and exercise, insulin injections may be necessary. Concentrated sugars should be avoided. Weight gain should continue, but not in excessive amounts. Usually, gestational diabetes disappears after the infant is born. However, diabetes can develop 5 to 10 years after the pregnancy”
The nurse is teaching a community class to peole with Type 2 diabetes mellitus. Which explanation would explain the development of Type 2 diabetes?
- The islet cells in the pancreas stop producing insulin.
- The client eats too many foods that are high in sugar.
- The pituitary gland does not produce vasopression.
- The cells become resistant to the circulating insulin.
- The cells become resistant to the circulating insulin.
Normally insulin binds to special receptor sites on the cells and initiates a series of reactions involved in metabolism. In Type 2 diabetes these reactions are diminished primarily as a result of obesity and aging.”
