Glucose Regulation

Question 1

The nurse instructs a patient with type 1 diabetes mellitus to avoid which of the following drugs while taking insulin?

Answer 1

Furosemide (Lasix)

Furosemide is a loop diuretic and can increase serum glucose levels; its use is contraindicated
with insulin.

Question 2

When a diabetic patient asks about maintaining adequate blood glucose levels, which of the
following statements by the nurse relates most directly to the necessity of maintaining blood
glucose levels no lower than about 74 mg/dL?

Answer 2

“The central nervous system cannot store glucose and needs a continuous supply of glucose for fuel.”

The brain cannot synthesize or store significant amounts of glucose; thus a continuous supply from the body’s circulation is needed to meet the fuel demands of the central nervous system.

Question 3

What is the nurse’s best response about developing diabetes to the patient whose father has type 1 diabetes mellitus?

Answer 3

“You have a greater susceptibility for development of the disease because of your family history.”

Even though type 1 diabetes does not follow a specific genetic pattern of inheritance, those with one parent with type 1 diabetes are at an increased risk for development of the disease

Question 4

The nurse recognizes which patient as having the greatest risk for undiagnosed diabetes
mellitus?

Answer 4

Middle-aged Native American woman

The highest incidence of diabetes in the United States occurs in Native Americans. With age, the incidence of diabetes increases in all races and ethnic groups.

Question 5

A diabetic patient is brought into the emergency department unresponsive. The arterial pH is
7.28. Besides the blood pH, which clinical manifestation is seen in uncontrolled diabetes mellitus and ketoacidosis?

Answer 5

Increased respiratory rate

Ketoacidosis decreases the pH of the blood, stimulating the respiratory control area of the
brain to buffer the effects of the increasing acidosis. The rate and depth of respirations are increased (Kussmaul’s respirations) to excrete more acids by exhalation. Usually polydipsia (increased thirst), polyphagia (increased hunger), and polyuria (increased urine output) are
seen with hyperglycemia and ketoacidosis.

Question 6

Which of the following would be included in the assessment of a patient with diabetes mellitus who is experiencing a hypoglycemic reaction? (Multiple Response)

Answer 6

Tremors
Nervousness
Profuse perspiration

When hypoglycemia occurs, blood glucose levels fall, resulting in sympathetic nervous system responses such as tremors, nervousness, and profuse perspiration