A client with diabetes mellitus has a prescription for 5 units of U-100 regular insulin and 25 units of U-100 isophane insulin suspension (NPH) to be taken before breakfast. At about 4:30 p.m., the client experiences headache, sweating, tremor, pallor, and nervousness. What is the most probable cause of these signs and symptoms?
answer
Serum glucose level of 52 mg/dl
Headache, sweating, tremor, pallor, and nervousness typically result from hypoglycemia, an insulin reaction in which serum glucose level drops below 70 mg/dl
question
A client's blood glucose level is 45 mg/dl. The nurse should be alert for which signs and symptoms?
answer
Coma, anxiety, confusion, headache, and cool, moist skin
Signs and symptoms of hypoglycemia (indicated by a blood glucose level of 45 mf/dl) include anxiety, restlessness, headache, irritability, confusion, diaphoresis, cool skin, tremors, coma, and seizures.
question
A client tells the nurse that she has been working hard for the past 3 months to control her type 2 diabetes with diet and exercise. To determine the effectiveness of the client's efforts, the nurse should check:
answer
glycosylated hemoglobin level.
Because some of the glucose in the bloodstream attaches to some of the hemoglobin and stays attached during the 120-day life span of red blood cells, glycosylated hemoglobin levels provide information about blood glucose levels during the previous 3 months.
question
A client is admitted with hyperosmolar hyperglycemic nonketotic syndrome (HHNS). Which laboratory finding should the nurse expect in this client?
answer
Blood glucose level 1,100 mg/dl
The blood glucose level rises to above 600 mg/dl in response to illness or infection
question
Which clinical characteristic is associated with type 2 diabetes (previously referred to as non-insulin-dependent diabetes mellitus)?
answer
Blood glucose can be controlled through diet and exercise
question
Which information should be included in the teaching plan for a client receiving glargine, which is "peakless" basal insulin?
answer
Do not mix with other insulins.
Because glargine is in a suspension with a pH of 4, it cannot be mixed with other insulins because this would cause precipitation. Glargine is a "peakless" basal insulin that is absorbed very slowly over a 24-hour period and can be given once a day.
question
Which may be a potential cause of hypoglycemia in the client diagnosed with diabetes mellitus?
answer
The client has not eaten but continues to take insulin or oral antidiabetic medications.
question
Glycosylated hemoglobin reflects blood glucose concentrations over which period of time?
answer
3 months
question
A client with type 2 diabetes asks the nurse why he can't have a pancreatic transplant. Which of the following would the nurse include as a possible reason?
answer
Underlying problem of insulin resistance
question
A client with diabetes is receiving an oral antidiabetic agent that acts to help the tissues use available insulin more efficiently. Which of the following agents would the nurse expect to administer?
answer
Metformin
question
A client has been diagnosed with prediabetes and discusses treatment strategies with the nurse. What can be the consequences of untreated prediabetes?
answer
The NIDDK has developed criteria that identify people with prediabetes, which can lead to type 2 diabetes, heart disease, and stroke.
question
A client with a history of type 1 diabetes is demonstrating fast, deep, labored breathing and has fruity odored breath. What could be the cause of the client's current serious condition?
answer
ketoacidosis
question
A client is admitted to the unit with diabetic ketoacidosis (DKA). Which insulin would the nurse expect to administer intravenously?
answer
Regular
Regular insulin is administered intravenously to treat DKA.
question
The diabetic client asks the nurse why shoes and socks are removed at each office visit. Which assessment finding is most significant in determining the protocol for inspection of feet?
answer
Sensory neuropathy
Neuropathy results from poor glucose control and decreased circulation to nerve tissues.
question
A client is admitted to the health care center with abdominal pain, nausea, and vomiting. The medical reports indicate a history of type 1 diabetes. The nurse suspects the client's symptoms to be those of diabetic ketoacidosis (DKA). Which action will help the nurse confirm the diagnosis?
answer
Assess the client's breath odor
question
A nurse is caring for a diabetic patient with a diagnosis of nephropathy. What would the nurse expect the urinalysis report to indicate?
answer
Albumin
question
The nurse is administering an insulin drip to a patient in ketoacidosis. What insulin does the nurse know is the only one that can be used intravenously?
answer
Regular
Short-acting insulins are called regular insulin (marked R on the bottle)
question
The pancreas continues to release a small amount of basal insulin overnight, while a person is sleeping. The nurse knows that if the body needs more sugar:
answer
The pancreatic hormone glucagon will stimulate the liver to release stored glucose.
When sugar levels are low, glucagon promotes hyperglycemia by stimulating the release of stored glucose.
question
A patient who is 6 months' pregnant was evaluated for gestational diabetes mellitus. The doctor considered prescribing insulin based on the serum glucose result of:
answer
138 mg/dL, 2 hours postprandial.
The goals for a 2-hour, postprandial blood glucose level are less than 120 mg/dL in a patient who might develop gestational diabetes.
question
Health teaching for a patient with diabetes who is prescribed Humulin N, an intermediate NPH insulin, would include which of the following advice?
answer
"You should take your insulin after you eat breakfast and dinner."
question
A client with long-standing type 1 diabetes is admitted to the hospital with unstable angina pectoris. After the client's condition stabilizes, the nurse evaluates the diabetes management regimen. The nurse learns that the client sees the physician every 4 weeks, injects insulin after breakfast and dinner, and measures blood glucose before breakfast and at bedtime. Consequently, the nurse should formulate a nursing diagnosis of:
answer
Deficient knowledge (treatment regimen).
The client should inject insulin before, not after, breakfast and dinner — 30 minutes before breakfast for the a.m. dose and 30 minutes before dinner for the p.m. dose.
question
A client is diagnosed with diabetes mellitus. Which assessment finding best supports a nursing diagnosis of Ineffective coping related to diabetes mellitus?
answer
Crying whenever diabetes is mentioned
question
A nurse explains to a client that she will administer his first insulin dose in his abdomen. How does absorption at the abdominal site compare with absorption at other sites?
answer
Insulin is absorbed more rapidly at abdominal injection sites than at other sites.
question
Which instruction about insulin administration should a nurse give to a client?
answer
"Always follow the same order when drawing the different insulins into the syringe."
question
A nurse is caring for a client with type 1 diabetes who exhibits confusion, light-headedness, and aberrant behavior. The client is conscious. The nurse should first administer:
answer
15 to 20 g of a fast-acting carbohydrate such as orange juice.
question
A client with status asthmaticus requires endotracheal intubation and mechanical ventilation. Twenty-four hours after intubation, the client is started on the insulin infusion protocol. The nurse must monitor the client's blood glucose levels hourly and watch for which early signs and symptoms associated with hypoglycemia?
answer
Sweating, tremors, and tachycardia
question
NPH is an example of which type of insulin?
answer
Intermediate-acting
question
Which statement is true regarding gestational diabetes?
answer
A glucose challenge test should be performed between 24 to 28 weeks.
question
The nurse is describing the action of insulin in the body to a client newly diagnosed with type 1 diabetes. Which of the following would the nurse explain as being the primary action?
answer
It enhances transport of glucose across the cell wall.
question
The nurse is preparing a presentation for a group of adults at a local community center about diabetes. Which of the following would the nurse include as associated with type 2 diabetes?
answer
Insulin production insufficient
question
After teaching a client with type 1 diabetes who is scheduled to undergo an islet cell transplant, which client statement indicates successful teaching?
answer
"I might need insulin later on but probably not as much or as often."
question
What is the only insulin that can be given intravenously?
answer
Regular
question
A client with diabetes mellitus has a blood glucose level of 40 mg/dL. Which rapidly absorbed carbohydrate would be most effective?
answer
1/2 cup fruit juice or regular soft drink
question
A male client, aged 42 years, is diagnosed with diabetes mellitus. He visits the gym regularly and is a vegetarian. Which of the following factors is important when assessing the client?
answer
The client's consumption of carbohydrates
While assessing a client, it is important to note the client's consumption of carbohydrates because he has high blood sugar.
question
Which factor presents the most likely cause for weight gain in a diabetic client who is controlled with insulin?
answer
Insulin is an anabolic hormone.
Insulin is an anabolic hormone that is known to cause weight gain
question
The nurse is administering lispro insulin. Based on the onset of action, how long before breakfast should the nurse administer the injection?
answer
10 to 15 minutes
question
The nurse is teaching a client about self-administration of insulin and about mixing regular and neutral protamine Hagedorn (NPH) insulin. Which information is important to include in the teaching plan?
answer
When mixing insulin, the regular insulin is drawn up into the syringe first.
question
During a follow-up visit 3 months after a new diagnosis of type 2 diabetes, a client reports exercising and following a reduced-calorie diet. Assessment reveals that the client has only lost 1 pound and did not bring the glucose-monitoring record. Which value should the nurse measure?
answer
Glycosylated hemoglobin level
question
The nurse is caring for a client with an abnormally low blood glucose concentration. What glucose level will the nurse observe when assessing laboratory results?
answer
Lower than 50 to 60 mg/dL (2.77 to 3.33 mmol/L)
question
A health care provider prescribes short-acting insulin for a patient, instructing the patient to take the insulin 20 to 30 minutes before a meal. The nurse explains to the patient that Humulin-R taken at 6:30 AM will reach peak effectiveness by:
answer
8:30am
question
A nurse is teaching a client with type 1 diabetes how to treat adverse reactions to insulin. To reverse hypoglycemia, the client ideally should ingest an oral carbohydrate. However, this treatment isn't always possible or safe. Therefore, the nurse should advise the client to keep which alternate treatment on hand?
answer
Glucagon
question
During a class on exercise for clients with diabetes mellitus, a client asks the nurse educator how often to exercise. To meet the goals of planned exercise, the nurse educator should advise the client to exercise:
answer
at least three times per week.
question
A nurse is providing dietary instructions to a client with hypoglycemia. To control hypoglycemic episodes, the nurse should recommend:
answer
consuming a low-carbohydrate, high-protein diet and avoiding fasting.
question
A client with type 1 diabetes must undergo bowel resection in the morning. How should the nurse proceed while caring for him on the morning of surgery?
answer
Administer half of the client's typical morning insulin dose as ordered.
If the nurse administers the client's normal daily dose of insulin while he's on nothing-by-mouth status before surgery, he'll experience hypoglycemia.
question
Which type of insulin acts most quickly?
answer
Lispro
question
A client with diabetes mellitus is receiving an oral antidiabetic agent. The nurse observes for which symptom when caring for this client?
answer
Hypoglycemia
question
Which clinical manifestation of type 2 diabetes occurs if glucose levels are very high?
answer
Blurred vision
question
A nurse educates a group of clients with diabetes mellitus on the prevention of diabetic nephropathy. Which of the following suggestions would be most important?
answer
Control blood glucose levels.
question
A client with diabetes comes to the clinic for a follow-up visit. The nurse reviews the client's glycosylated hemoglobin test results. Which result would indicate to the nurse that the client's blood glucose level has been well-controlled?
answer
6.5%
question
nsulin is secreted by which of the following types of cells?
answer
Beta cells
question
A client has been recently diagnosed with type 2 diabetes, and reports continued weight loss despite increased hunger and food consumption. This condition is called:
answer
polyphagia.
The person with diabetes feels hungry and eats more (polyphagia). Despite eating more, he or she loses weight as the body uses fat and protein to substitute for glucose.
question
The nurse is explaining glycosylated hemoglobin testing to a diabetic client. Which of the following provides the best reason for this order?
answer
Reflects the amount of glucose stored in hemoglobin over past several months.
question
The client who is managing diabetes through diet and insulin control asks the nurse why exercise is important. Which is the best response by the nurse to support adding exercise to the daily routine?
answer
Increases ability for glucose to get into the cell and lowers blood sugar
question
A 1200-calorie diet and exercise are prescribed for a client with newly diagnosed type 2 diabetes. The nurse is teaching the client about meal planning using exchange lists. The teaching is determined to be effective based on which statement by the client?
answer
"For dinner I ate a 3-ounce hamburger on a bun, with ketchup, pickle, and onion; a green salad with 1 teaspoon Italian dressing; 1 cup of watermelon; and a diet soda."
There are six main exchange lists: bread/starch, vegetable, milk, meat, fruit, and fat. Foods within one group (in the portion amounts specified) contain equal numbers of calories and are approximately equal in grams of protein, fat, and carbohydrate.
question
A client with type 1 diabetes is experiencing polyphagia. The nurse knows to assess for which additional clinical manifestation(s) associated with this classic symptom?
answer
Muscle wasting and tissue loss
question
The nurse is preparing to administer intermediate-acting insulin to a patient with diabetes. Which insulin will the nurse administer?
answer
NPH
question
A patient who is diagnosed with type 1 diabetes would be expected to:
answer
Need exogenous insulin.
Type 1 diabetes is characterized by the destruction of pancreatic beta cells that require exogenous insulin.
question
An agitated, confused client arrives in the emergency department. The client's history includes type 1 diabetes, hypertension, and angina pectoris. Assessment reveals pallor, diaphoresis, headache, and intense hunger. A stat blood glucose sample measures 42 mg/dl, and the client is treated for an acute hypoglycemic reaction. After recovery, the nurse teaches the client to treat hypoglycemia by ingesting:
answer
10 to 15 g of a simple carbohydrate.
o reverse hypoglycemia, the American Diabetes Association recommends ingesting 10 to 15 g of a simple carbohydrate, such as three to five pieces of hard candy, two to three packets of sugar (4 to 6 tsp), or 4 oz of fruit juice.
question
A client with diabetes mellitus must learn how to self-administer insulin. The physician has ordered 10 units of U-100 regular insulin and 35 units of U-100 isophane insulin suspension (NPH) to be taken before breakfast. When teaching the client how to select and rotate insulin injection sites, the nurse should provide which instruction?
answer
"Rotate injection sites within the same anatomic region, not among different regions."
Rotating sites among different regions may cause excessive day-to-day variations in the blood glucose level; also, insulin absorption differs from one region to the next.
question
A nurse is teaching a client with diabetes mellitus about self-management of his condition. The nurse should instruct the client to administer 1 unit of insulin for every:
answer
15 g of carbohydrates.
question
Which statement indicates that a client with diabetes mellitus understands proper foot care?
answer
"I'll wear cotton socks with well-fitting shoes."
question
A nurse expects to find which signs and symptoms in a client experiencing hypoglycemia?
answer
Nervousness, diaphoresis, and confusion
question
A client with type 1 diabetes presents with a decreased level of consciousness and a fingerstick glucose level of 39 mg/dl. His family reports that he has been skipping meals in an effort to lose weight. Which nursing intervention is most appropriate?
answer
Administering 1 ampule of 50% dextrose solution, per physician's order
question
A nurse is preparing a client with type 1 diabetes for discharge. The client can care for himself; however, he's had a problem with unstable blood glucose levels in the past. Based on the client's history, he should be referred to which health care worker?
answer
Dietitian
question
Which intervention is essential when performing dressing changes on a client with a diabetic foot ulcer?
answer
Using sterile technique during the dressing change
question
The nurse is educating the client with diabetes on setting up a sick plan to manage blood glucose control during times of minor illness such as influenza. Which is the most important teaching item to include?
answer
Increase frequency of glucose self-monitoring.
The body's need for insulin increases during illness.
question
A nurse is teaching a client recovering from diabetic ketoacidosis (DKA) about management of "sick days." The client asks the nurse why it is important to monitor the urine for ketones. Which statement is the nurse's best response?
answer
"Ketones accumulate in the blood and urine when fat breaks down in the absence of insulin. Ketones signal an insulin deficiency that will cause the body to start breaking down stored fat for energy."
question
A 16-year-old client newly diagnosed with type 1 diabetes has a very low body weight despite eating regular meals. The client is upset because friends frequently state, "You look anorexic." Which statement by the nurse would be the best response to help this client understand the cause of weight loss due to this condition?
answer
"Your body is using protein and fat for energy instead of glucose."
question
A 60-year-old client comes to the ED reporting weakness, vision problems, increased thirst, increased urination, and frequent infections that do not seem to heal easily. The physician suspects that the client has diabetes. Which classic symptom should the nurse watch for to confirm the diagnosis of diabetes?
answer
Increased hunger
The classic symptoms of diabetes are the three Ps: polyuria (increased urination), polydipsia (increased thirst), and polyphagia (increased hunger).
question
A patient has been newly diagnosed with type 2 diabetes, and the nurse is assisting with the development of a meal plan. What step should be taken into consideration prior to making the meal plan?
answer
Reviewing the patient's diet history to identify eating habits and lifestyle and cultural eating patterns
question
A client has type 1 diabetes. Her husband finds her unconscious at home and administers glucagon, 0.5 mg subcutaneously. She awakens in 5 minutes. Why should her husband offer her a complex carbohydrate snack as soon as possible?
answer
To restore liver glycogen and prevent secondary hypoglycemia
question
A client with type 1 diabetes asks the nurse about taking an oral antidiabetic agent. The nurse explains that these medications are effective only if the client:
answer
has type 2 diabetes.
question
A physician orders blood glucose levels every 4 hours for a 4-year-old child with brittle type 1 diabetes. The parents are worried that drawing so much blood will traumatize their child. How can the nurse best reassure the parents?
answer
"Your child will need less blood work as his glucose levels stabilize."
question
When administering insulin to a client with type 1 diabetes, which of the following would be most important for the nurse to keep in mind?
answer
Accuracy of the dosage
question
A nurse is providing education to a client who is newly diagnosed with diabetes mellitus. What are classic symptoms associated with diabetes?
answer
increased thirst, hunger, and urination
question
A client is admitted to the health care center with abdominal pain, nausea, and vomiting. The medical reports indicate a history of type 1 diabetes. The nurse suspects the client's symptoms to be those of diabetic ketoacidosis (DKA). Which action will help the nurse confirm the diagnosis?
answer
Assess the client's breath odor
question
A client is evaluated for type 1 diabetes. Which client comment correlates best with this disorder?
answer
"I'm thirsty all the time. I just can't get enough to drink."
question
Which combination of adverse effects should a nurse monitor for when administering IV insulin to a client with diabetic ketoacidosis?
answer
Hypokalemia and hypoglycemia
question
A client with a tentative diagnosis of hyperosmolar hyperglycemic nonketotic syndrome (HHNS) has a history of type 2 diabetes that is being controlled with an oral diabetic agent, tolazamide. Which laboratory test is the most important for confirming this disorder?
answer
Serum osmolarity
Serum osmolarity is the most important test for confirming HHNS;
question
Lispro (Humalog) is an example of which type of insulin?
answer
Rapid-acting
question
What is the duration of regular insulin?
answer
4 to 6 hours
question
A nurse is teaching a diabetic support group about the causes of type 1 diabetes. The teaching is determined to be effective when the group is able to attribute which factor as a cause of type 1 diabetes?
answer
Presence of autoantibodies against islet cells
question
A nurse is assessing a client who is receiving total parenteral nutrition (TPN). Which finding suggests that the client has developed hyperglycemia?
answer
Increased urine output
question
Which instruction should a nurse give to a client with diabetes mellitus when teaching about "sick day rules"?
answer
Test blood glucose every 4 hours
The nurse should instruct a client with diabetes mellitus to check his blood glucose levels every 3 to 4 hours and take insulin or an oral antidiabetic agent as usual, even when he's sick. If the client's blood glucose level rises above 300 mg/dl, he should call his physician immediately. If the client is unable to follow the regular meal plan because of nausea, he should substitute soft foods, such as gelatin, soup, and custard.
question
A client with diabetes mellitus develops sinusitis and otitis media accompanied by a temperature of 100.8° F (38.2° C). What effect do these findings have on his need for insulin?
answer
They increase the need for insulin
Insulin requirements increase in response to growth, pregnancy, increased food intake, stress, surgery, infection, illness, increased insulin antibodies, and some medications. Insulin requirements are decreased by hypothyroidism, decreased food intake, exercise, and some medications.
question
A nurse is preparing the daily care plan for a client with newly diagnosed diabetes mellitus. The priority nursing concern for this client should be:
answer
Providing client education at every opportunity
question
Which clinical characteristic is associated with type 1 diabetes (previously referred to as insulin-dependent diabetes mellitus)?
answer
Presence of Islet cell antibodies
Individuals with type 1 diabetes often have islet cell antibodies and are usually thin or demonstrate recent weight loss at the time of diagnosis. These individuals are prone to experiencing ketosis when insulin is absent and require exogenous insulin to preserve life.
question
Which of the following factors would a nurse identify as a most likely cause of diabetic ketoacidosis (DKA) in a client with diabetes?
answer
The client has eaten and has not taken or received insulin.
question
A nurse is preparing to administer two types of insulin to a client with diabetes mellitus. What is the correct procedure for preparing this medication?
answer
The short-acting insulin is withdrawn before the intermediate-acting insulin.
When combining two types of insulin in the same syringe, the short-acting regular insulin is withdrawn into the syringe first and the intermediate-acting insulin is added next. This practice is referred to as "clear to cloudy."
question
Which assessment finding is most important in determining nursing care for a client with diabetes mellitus?
answer
Fruity breath
question
A nurse is teaching a client recovering from diabetic ketoacidosis (DKA) about management of "sick days." The client asks the nurse why it is important to monitor the urine for ketones. Which statement is the nurse's best response?
answer
"Ketones accumulate in the blood and urine when fat breaks down in the absence of insulin. Ketones signal an insulin deficiency that will cause the body to start breaking down stored fat for energy."
Ketones (or ketone bodies) are by-products of fat breakdown in the absence of insulin, and they accumulate in the blood and urine. Ketones in the urine signal an insulin deficiency and that control of type 1 diabetes is deteriorating. When almost no effective insulin is available, the body starts to break down stored fat for energy.
question
A 16-year-old client newly diagnosed with type 1 diabetes has a very low body weight despite eating regular meals. The client is upset because friends frequently state, "You look anorexic." Which statement by the nurse would be the best response to help this client understand the cause of weight loss due to this condition?
answer
Your body is using protein and fat for energy instead of glucose
question
The nurse is preparing to administer intermediate-acting insulin to a patient with diabetes. Which insulin will the nurse administer?
answer
NPH
Intermediate-acting insulins are called NPH insulin (neutral protamine Hagedorn) or Lente insulin. Lispro (Humalog) is rapid acting, Iletin II is short acting, and glargine (Lantus) is very long acting.
question
he nurse is educating the patient with diabetes about the importance of increasing dietary fiber. What should the nurse explain is the rationale for the increase? Select all that apply.
answer
May improve blood glucose levels
Decrease the need for exogenous insulin
Help reduce cholesterol levels
question
A client is receiving insulin lispro at 7:30 AM. The nurse ensures that the client has breakfast by which time?
answer
7:45 AM
Insulin lispro has an onset of 5 to 15 minutes. Therefore, the nurse would need to ensure that the client has his breakfast by 7:45 AM at the latest. Otherwise, the client may experience hypoglycemia.
question
An obese Hispanic client, age 65, is diagnosed with type 2 diabetes. Which statement about diabetes mellitus is true?
answer
More common in hispanics and blacks
question
A client who was diagnosed with type 1 diabetes 14 years ago is admitted to the medical-surgical unit with abdominal pain. On admission, the client's blood glucose level is 470 mg/dl. Which finding is most likely to accompany this blood glucose level?
answer
Rapid, thready pulse
This client's abnormally high blood glucose level indicates hyperglycemia, which typically causes polyuria, polyphagia, and polydipsia. Because polyuria leads to fluid loss, the nurse should expect to assess signs of deficient fluid volume, such as a rapid, thready pulse; decreased blood pressure; and rapid respirations. Cool, moist skin and arm and leg trembling are associated with hypoglycemia. Rapid respirations — not slow, shallow ones — are associated with hyperglycemia.
question
A client has just been diagnosed with type 1 diabetes. When teaching the client and family how diet and exercise affect insulin requirements, the nurse should include which guideline?
answer
"You'll need less insulin when you exercise or reduce your food intake."
he nurse should advise the client that exercise, reduced food intake, hypothyroidism, and certain medications decrease insulin requirements. Growth, pregnancy, greater food intake, stress, surgery, infection, illness, increased insulin antibodies, and certain medications increase insulin requirements.
question
A nurse is assigned to care for a postoperative client with diabetes mellitus. During the assessment interview, the client reports that he's impotent and says he's concerned about the effect on his marriage. In planning this client's care, the most appropriate intervention would be to:
answer
Suggest referral to sex therapist/ other appropriate professional
question
A client newly diagnosed with diabetes mellitus asks why he needs ketone testing when the disease affects his blood glucose levels. How should the nurse respond?
answer
Ketones will tell us if your body is using other tissues for energy
The nurse should tell the client that ketones are a byproduct of fat metabolism and that ketone testing can determine whether the body is breaking down fat to use for energy. The spleen doesn't release ketones when the body can't use glucose. Although ketones can damage the eyes and kidneys and help the physician evaluate the severity of a client's diabetes, these responses by the nurse are incomplete.
question
Which of the following insulins are used for basal dosage?
answer
Glarginet (Lantus)
Lantus is used for basal dosage. NPH is an intermediate acting insulin, usually taken after food. Humalog and Novolog are rapid-acting insulins.
question
Which factors will cause hypoglycemia in a client with diabetes? Select all that apply.
answer
Client has not consumed food and continues to take insulin or oral antidiabetic medications.
Client has not consumed sufficient calories.
Client has been exercising more than usual.
question
Which is the best nursing explanation for the symptom of polyuria in a client with diabetes mellitus?
answer
High sugar pulls fluid into the bloodstream, which results in more urine production.
question
A client with type 1 diabetes reports waking up in the middle of the night feeling nervous and confused, with tremors, sweating, and a feeling of hunger. Morning fasting blood glucose readings have been 110 to 140 mg/dL. The client admits to exercising excessively and skipping meals over the past several weeks. Based on these symptoms, the nurse plans to instruct the client to
answer
Check blood glucose at 3:00 a.m.
In the Somogyi effect, the client has a normal or elevated blood glucose concentration at bedtime, which decreases to hypoglycemic levels at 2 to 3 a.m., and subsequently increases as a result of the production of counter-regulatory hormones. It is important to check blood glucose in the early morning hours to detect the initial hypoglycemia.
question
A child is brought into the emergency department with vomiting, drowsiness, and blowing respirations. The father reports that the symptoms have been progressing throughout the day. The nurse suspects diabetic ketoacidosis (DKA). Which action should the nurse take first in the management of DKA?
answer
Begin fluid replacements
Management of DKA is aimed at correcting dehydration, electrolyte loss, and acidosis before correcting the hypoglycemia with insulin.
question
A patient is diagnosed with type 1 diabetes. What clinical characteristics does the nurse expect to see in this patient? Select all that apply.
answer
Ketosis-prone
Little endogenous insulin
Younger than 30 years of age
question
he nurse is educating a patient about the benefits of fruit versus fruit juice in the diabetic diet. The patient states, "What difference does it make if you drink the juice or eat the fruit? It is all the same." What is the best response by the nurse?
answer
"Eating the fruit instead of drinking juice decreases the glycemic index by slowing absorption."
Eating whole fruit instead of drinking juice decreases the glycemic index, because fiber in the fruit slows absorption.
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