health alterations - week 1

Question 1

What are the three main categories of diabetes mellitus?

Answer 1

Type 1, type 2, gestational diabetes

Question 2

Why do people with Type 1 Diabetes Mellitus experience weight loss?

Answer 2

Osmotic diuresis and loss of body tissue (fats & proteins) for energy production.

Question 3

The nurse is assessing a 22-yr-old patient experiencing the onset of symptoms of type 1 diabetes. To which question would the nurse anticipate a positive response?

Answer 3

“Have you lost weight lately?”

Question 4

What is the pathophysiology of Type 1 Diabetes Mellitus

Answer 4

Auto-immune mediated destruction of the islet cells of the pancreas leads to a severe or absolute lack of insulin production.

Question 5

What is diabetes mellitus?

Answer 5

A group of disorders with chronic hyperglycaemia and other disturbances of carbohydrate, protein and fat metabolism.

Question 6

Which statement by a nurse to a patient newly diagnosed with type 2 diabetes is correct?

Answer 6

Changes in diet and exercise may control blood glucose levels in type 2 diabetes.
For some patients with type 2 diabetes, changes in lifestyle are sufficient to achieve blood glucose control.

Question 7

What happens to insulin production in Type 2 diabetes mellitus?

Answer 7

Initially production is normal or high, later it decreases.

Question 8

Gestational diabetes…

Answer 8

Is glucose intolerance that appears during pregnancy

Question 9

Why do people with uncontrolled Type 1 Diabetes Mellitus experience polydipsia?

Answer 9

Polyuria leads to dehydration, which triggers the thirst mechanism.

Question 10

What is the impact of the development of thicker capillary walls in diabetes mellitus?

Answer 10

• Blood vessels in the retina haemorrhage
• Blood vessels in the glomeruli harden decreasing the filtration rate
• Glucose molecules embed into larger blood vessel walls leading to atherosclerosis.

Question 11

The glycated haemoglobin A1c test…

Answer 11

Indicates glucose control over recent weeks

Question 12

What is the most powerful risk factor for type 2 diabetes mellitus?

Answer 12

Obesity, especially abdominal obesity

Question 13

Signs and symptoms of hypoglycaemia include….

Answer 13

Tachycardia, diaphoresis, tremors, hunger, restlessness, progressing to seizure, coma & death

Question 14

According to the World Health Organisation, what fasting blood glucose test result indicates that diabetes is unlikely?

Answer 14

< 6.1 mmol/L

Question 15

What proportion of Australians with diabetes mellitus have Type 1 DM?

Answer 15

10

Question 16

Normal BGL after meal

Answer 16

<7.7

Question 17

BGL during a hypo is

Answer 17

<4

Question 18

BGL during hyper is

Answer 18

> 15

Question 19

HbA1C is healthy individual is

Answer 19

<5.7%

Question 20

HbA1c during pre-DM

Answer 20

5.7 - 6.4%

Question 21

Fasting BGL with DM

Answer 21

> 7

Question 22

The nurse is assessing a 55-yr-old female patient with type 2 diabetes who has a body mass index (BMI) of 31 kg/m2.Which goal in the plan of care is most important for this patient?

Answer 22

The patient will reach a glycosylated haemoglobin level of 7% or less.

Question 23

What BMI is considered obese?

Answer 23

<31kg/m2

Question 24

Why do people with uncontrolled Type 1 Diabetes Mellitus experience polyphagia?

Answer 24

Because glucose and lipids do not enter cells in sufficient amounts, this stimulates increase food intake.

Question 25

How are ketones related to Type 1 Diabetes Mellitus?

Answer 25

• Fat and protein metabolism leads to ketone bodies.
• Ketone bodies are acidic
• Increasing ketone levels indicate severe illness.

Question 26

To assist an older patient with diabetes to engage in moderate daily exercise, which action is most important for the nurse to take?

Answer 26

Determine what types of activities the patient enjoys.
Because consistency with exercise is important, assessment for the types of exercise that the patient finds enjoyable is the most important action by the nurse in ensuring adherence to an exercise program

Question 27

When a patient who takes metformin to manage type 2 diabetes develops an allergic rash from an unknown cause, the health care provider prescribes prednisone. The nurse will anticipate that the patient may

Answer 27

require administration of insulin while taking prednisone.

Glucose levels increase when patients are taking corticosteroids, and insulin may be required to control blood glucose.

Question 28

The nurse is preparing to teach a 43-yr-old man who is newly diagnosed with type 2 diabetes about home management of the disease. Which action should the nurse take first?

Answer 28

Assess the patient’s perception of what it means to have diabetes mellitus

Question 29

The nurse is taking a health history from a 29-yr-old pregnant patient at the first prenatal visit. The patient reports that she has no personal history of diabetes, but her mother has diabetes. Which action will the nurse plan to take?

Answer 29

Schedule the patient for a fasting blood glucose level.

Patients at high risk for gestational diabetes should be screened for diabetes on the initial prenatal visit

Question 30

A 30-yr-old patient has a new diagnosis of type 2 diabetes. The nurse will discuss the need to schedule a dilated eye examination

Answer 30

as soon as possible.

Because many patients have some diabetic retinopathy when they are first diagnosed with type 2 diabetes, a dilated eye examination is recommended at the time of diagnosis and annually thereafter.