Chapter 50

43問 • 1年前

問題一覧

A teaching plan for a patient with diabetes is focused on smoking cessation and the control of hypertension for the avoidance of microvascular complications. What are examples of microvascular complications? (Select all that apply.)

Macular degeneration, End-stage renal disease (ESRD)

How is the Whipple triad described? (Select all that apply.)

Symptoms of hypoglycemia are present., Low blood glucose levels are documented when symptoms are present, Symptoms improved when the blood glucose level rises.

A nurse reminds a patient with type I diabetes to rotate the insulin injection sites to prevent ______.

lipohypertrophy

A nurse explains that type 1 diabetes mellitus is a disease in which the body does not produce enough insulin. What statement provides the reason that blood glucose is elevated?

Destruction of the beta cells in the pancreas

A patient newly diagnosed with type 2 diabetes mellitus asks the nurse why she has to take a pill instead of insulin. The nurse explains that in type 2 diabetes mellitus, the body still makes insulin. Which other information is pertinent for the nurse to relay?

The cells become resistant to the action of insulin. Pills are given to increase the sensitivity.

A patient tells a nurse that she eats "huge" amounts of food but stays hungry most of the time. Which explanation should the nurse provide as the cause of hunger experienced by persons with type 1 diabetes?

Fact that the cells cannot use the blood glucose

Which process does the lack of insulin in patients with type 1 diabetes cause that increases the risk for cardiovascular disorders?

Increased fatty acid levels

The self-care goal of a patient with diabetes is to keep the blood sugar within normal limits. Which factor causes hyperglycemia to occur?

The body responds to glucose -starved tissues by changing stored glycogen into glucose.

A young patient complains that diabetes is causing her to "have no life at all. It's too hard." Which is the most helpful response by the nurse?

Let's talk about what makes it so hard."

When a patient with type 2 diabetes says, "Why in the world are they looking at my hemoglobin? I thought my problem was with my blood sugar." Which information should the nurse explain about the level of hemoglobin A1c?

Shows what the glucose level has done during the past 3 months

A patient with type 2 diabetes shows a blood sugar reading of 68 at 6 AM. Which action should the nurse implement based on the reading of 72 mg/dL?

Give him 8 oz of skim milk.

A nurse assigned to care for a patient with diabetic ketoacidosis (DKA) is aware that this is a life-threatening condition. Which result is attributed to DKA?

Disorder of carbohydrates, fats, and proteins metabolism

A patient has been admitted to the hospital with the diagnosis of DKA. Which vital signs should a nurse anticipate that the patient will exhibit?

Temperature, 97.4 F; pulse, 110 beats/min; respirations, 26 breaths/min and deep

A home health care nurse is assessing a patient with type 1 diabetes who has been controlled for 6 months. The nurse is surprised and concerned about a blood glucose reading of 52 mg/dL. Which action by this patient most likely caused this episode of hypoglycemia?

A 2-hour long exercise class at the spa this morning

Which guideline should be included as part of a teaching plan in preparation for discharge of a patient with type 1 diabetes needing guidelines for exercise?

Exercise should be performed daily at the same time of day and at the same intensity.

A patient has come to the physician's office after finding out that her blood glucose level was 135 mg/dL. She states that she had not eaten before the test and was told to come and see her physician. She asks the nurse if she has diabetes. Which reply is the most accurate nursing response?

That test indicates that we need to perform more tests that are specific for diabetes."

A nurse is formulating a teaching plan for a 22-year-old woman taking rosiglitazone (Avandia). Which information should the nurse include in this plan to caution the patient?

Decreased effectiveness of her birth control pills

A patient with type 1 diabetes has an insulin order for NPH insulin, 35 U, to be given at 0700. The patient has also been instructed not to take anything by mouth (NPO) in preparation for laboratory work that will not be drawn until 1000. Which action should the nurse implement?

Hold the insulin until after the blood draw.

A patient comes to the diabetes clinic and confides to the nurse that she does not follow the diet exchange program that she was given. Which is the best response by the nurse?

Okay. Let's talk about what you eat and drink and how you manage your diabetes

A patient with type 1 diabetes asks why his 0700 insulin has been changed from NPH insulin to 70/30 premixed insulin. Which reply is the best explanation by the nurse that explains about 70/30 insulin mixture?

It makes insulin administration easier and safer.

Which intervention should a nurse include when drawing up a patient's diabetes teaching plan?

Develop an exercise plan because regular exercise helps control blood glucose levels.

Which situation has most likely occurred in a patient who has been diagnosed with endogenous hypoglycemia?

Excessive secretion of insulin or an increase in glucose metabolism

Which time correctly identifies how long it takes for Humulin R 20 units to peak?

2 hours

A nurse suspects that a patient with type 1 diabetes may be experiencing the Somogyi phenomenon. Which symptom supports this suspicion?

Headache on awakening and enuresis

A patient has been admitted with hyperglycemic hyperosmolar nonketotic syndrome (HHNS). The blood glucose level is very high (880 mg/dL) on admission. The physician believes that the condition is the result of large amounts of glucose solutions administered intravenously (IV) during renal dialysis. Which symptomsshould the nurse anticipate that the patient would exhibit?

Severe dehydration and hypernatremia caused by the hyperglycemia

Which functional causes relate to hypoglycemia? (Select all that apply.)

Dumping syndrome, Addison disease, Prolonged muscular exercise

Which information should a teaching plan about foot care include for a patient with diabetes? (Select all that apply.)

Wash and carefully dry the feet every day., Protect the feet from extreme temperatures., Buy shoes that are comfortable and supportive.

A teaching plan for a patient with diabetes is focused on smoking cessation and the control of hypertension for the avoidance of microvascular complications. Which disease processes are examples of microvascular complications? (Select all that apply.)

Macular degeneration, End-stage renal disease (ESRD)

Which statement(s) describe the Whipple triad? (Select all that apply.)

Symptoms of hypoglycemia are present., Low blood glucose levels are documented when symptoms are present., Symptoms improved when the blood glucose level rises.

A nurse is teaching a client with diabetes mellitus who asks, Why is it necessary to maintain my blood glucose levels no lower than about 60 mg/dL? How should the nurse respond?

Your brain needs a constant supply of glucose because it cannot store it.

A nurse reviews laboratory results for a client with diabetes mellitus who presents with polyuria, lethargy, and a blood glucose of 560 mg/dL. Which laboratory result should the nurse correlate with the clients polyuria?

Serum osmolarity: 375 mOsm/kg

After teaching a young adult client who is newly diagnosed with type 1 diabetes mellitus, the nurse assesses the clients understanding. Which statement made by the client indicates a correct understanding of the need for eye examinations?

"Diabetes can cause blindness, so I should see the ophthalmologist yearly."

A nurse assesses a client who has a 15-year history of diabetes and notes decreased tactile sensation in both feet. Which action should the nurse take first?

Examine the client's feet for signs of injury.

A nurse cares for a client who has a family history of diabetes mellitus. The client states, My father has type 1 diabetes mellitus. Will I develop this disease as well? How should the nurse respond?

"Your risk of diabetes is higher than the general population, but it may not occur."

A nurse teaches a client who is diagnosed with diabetes mellitus. Which statement should the nurse include in this clients plan of care to delay the onset of microvascular and macrovascular complications?

"Maintain tight glycemic control and prevent hyperglycemia."

A nurse assesses clients who are at risk for diabetes mellitus. Which client is at greatest risk?

A 58-year-old American Indian

A nurse teaches a client about self-monitoring of blood glucose levels. Which statement should the nurse include in this clients teaching to prevent bloodborne infections?

"Do not share your monitoring equipment."

A nurse teaches a client with type 2 diabetes mellitus who is prescribed glipizide (Glucotrol). Which statement should the nurse include in this clients teaching?

"Avoid taking nonsteroidal anti-inflammatory drugs (NSAIDs)."

After teaching a client with type 2 diabetes mellitus who is prescribed nateglinide (Starlix), the nurse assesses the clients understanding. Which statement made by the client indicates a correct understanding of the prescribed therapy?

"I will take this medicine immediately before I eat."

A nurse cares for a client who is prescribed pioglitazone (Actos). After 6 months of therapy, the client reports that his urine has become darker since starting the medication. Which action should the nurse take?

Review the client's liver function study results.

A nurse cares for a client with diabetes mellitus who asks, Why do I need to administer more than one injection of insulin each day? How should the nurse respond?

"A single dose of insulin each day would not match your blood insulin levels and your food intake patterns."

Which statement made by the client indicates a need for additional teaching?

The lower abdomen is the best location because it is closest to the pancreas.

A nurse assesses a client with diabetes mellitus and notes the client only responds to a sternal rub by moaning, has capillary blood glucose of 33 g/dL, and has an intravenous line that is infiltrated with 0.45% normal saline. Which action should the nurse take first?

Administer 1 mg of intramuscular glucagon.

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