Chapter 50 PT 3

41問 • 1年前

問題一覧

A nurse teaches a client who is prescribed an insulin pump. Which statement should the nurse include in this clients discharge education?

Change the needle every 3 days.

After teaching a client who has diabetes mellitus and proliferative retinopathy, nephropathy, and peripheral neuropathy, the nurse assesses the clients understanding. Which statement made by the client indicates a correct understanding of the teaching?

"I should look into swimming or water aerobics to get my exercise."

A nurse assesses a client who has diabetes mellitus. Which arterial blood gas values should the nurse identify as potential ketoacidosis in this client?

H 7.28, HCO3- 18 mEq/L, PCO2 28 mm Hg, PO2 98 mm Hg

A nurse cares for a client who has type 1 diabetes mellitus. The client asks, Is it okay for me to have an occasional glass of wine? How should the nurse respond?

"One glass of wine is okay with a meal and is counted as two fat exchanges."

A nurse teaches a client with type 1 diabetes mellitus. Which statement should the nurse include in this clients teaching to decrease the clients insulin needs?

"Walk at a moderate pace for 1 mile daily."

A nurse cares for a client who is diagnosed with acute rejection 2 months after receiving a simultaneous pancreas-kidney transplant. The client states, I was doing so well with my new organs, and the thought of having to go back to living on hemodialysis and taking insulin is so depressing. How should the nurse respond?

"One acute rejection episode does not mean that you will lose the new organs."

A nurse assesses a client with diabetes mellitus. Which clinical manifestation should alert the nurse to decreased kidney function in this client?

presence of protein in urine

A nurse assesses a client who has diabetes mellitus and notes the client is awake and alert, but shaky, diaphoretic, and weak. Five minutes after administering a half-cup of orange juice, the clients clinical manifestations have not changed. Which action should the nurse take next?

Administer another half-cup of orange juice.

A nurse reviews the laboratory results of a client who is receiving intravenous insulin. Which should alert the nurse to intervene immediately?

Serum potassium level of 2.5 mmol/L

A nurse teaches a client with diabetes mellitus about sick day management. Which statement should the nurse include in this clients teaching?

"Monitor your blood glucose levels at least every 4 hours while sick."

A nurse assesses a client who is being treated for hyperglycemic-hyperosmolar state (HHS). Which clinical manifestation indicates to the nurse that the therapy needs to be adjusted?

Glasgow Coma Scale score is unchanged

After teaching a client with type 2 diabetes mellitus, the nurse assesses the clients understanding. Which statement made by the client indicates a need for additional teaching?

Since my diabetes is controlled with diet and exercise, I must be seen only if I am sick.

After teaching a client who is newly diagnosed with type 2 diabetes mellitus, the nurse assesses the clients understanding. Which statement made by the client indicates a need for additional teaching?

"I should decrease my intake of protein and eliminate carbohydrates from my diet."

A nurse reviews laboratory results for a client with diabetes mellitus who is prescribed an intensified insulin regimen

Good control of blood glucose

A nurse prepares to administer insulin to a client at 1800. The clients medication administration record contains the following information:

Draw up and inject the insulin glargine first, and then draw up and inject the regular insulin.

A nurse reviews the chart and new prescriptions for a client with diabetic ketoacidosis:

Increase the intravenous rate and then consult with the provider about the potassium prescription.

At 4:45 p.m., a nurse assesses a client with diabetes mellitus who is recovering from an abdominal

Administer dextrose 50% intravenously and reassess the client.

A nurse provides diabetic education at a public health fair. Which disorders should the nurse include as complications of diabetes mellitus? (Select all that apply.)

Stroke, Kidney failure, Blindness

A nurse collaborates with the interdisciplinary team to develop a plan of care for a client who is newly diagnosed with diabetes mellitus. Which team members should the nurse include in this interdisciplinary team meeting? (Select all that apply.)

registered dietician, clinical pharmacist, health care provider

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

Changes in diet and exercise may control blood glucose levels in type 2 diabetes.

A patient screened for diabetes at a clinic has a fasting plasma glucose level of 120 mg/dL (6.7 mmol/L). The nurse will plan to teach the patient about

lifestyle changes to lower blood glucose.

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?

"Have you lost weight lately?"

The nurse determines a need for additional instruction when the patient with newly diagnosed type 1 diabetes says which of the following?

"I can choose any foods, as long as I use enough insulin to cover the calories."

Which statement by the patient indicates a need for additional instruction in administering insulin?

"I need to rotate injection sites among my arms, legs, and abdomen each day."

Which patient action indicates good understanding of the nurse's teaching about administration of aspart (NovoLog) insulin?

The patient cleans the skin with soap and water before insulin administration.

A patient receives aspart (NovoLog) insulin at 8:00 AM. At which time would the nurse anticipate the highest risk for hypoglycemia?

2:00 PM

Which patient action indicates a good understanding of the nurse's teaching about the use of an insulin pump?

The patient programs the pump for an insulin bolus after eating.

Which information will the nurse include when teaching a patient who has type 2 diabetes about glyburide

Glyburide stimulates insulin production and release from the pancreas.

The nurse has been teaching a patient with type 2 diabetes about managing blood glucose levels and taking glipizide (Glucotrol). Which patient statement indicates a need for additional teaching?

"My diabetes won't cause complications because I don't need insulin."

When a patient who takes metformin (Glucophage) 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

require administration of insulin while taking prednisone.

A hospitalized diabetic patient received 38 U of NPH insulin at 7:00 AM. At 1:00 PM, the patient has been away from the nursing unit for 2 hours, missing the lunch delivery while awaiting a chest x-ray. To prevent hypoglycemia, the best action by the nurse is to

request that if testing is further delayed, the patient be returned to the unit to eat.

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?

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

An unresponsive patient with type 2 diabetes is brought to the emergency department and diagnosed with hyperosmolar hyperglycemic syndrome (HHS). The nurse will anticipate the need to

insert an IV catheter.

A 26-yr-old female with type 1 diabetes develops a sore throat and runny nose after caring for her sick toddler. The patient calls the clinic for advice about her symptoms and a blood glucose level of 210 mg/dL despite taking her usual glargine (Lantus) and lispro (Humalog) insulin. The nurse advises the patient to

monitor blood glucose every 4 hours and notify the clinic if it continues to rise.

The health care provider suspects the Somogyi effect in a 50-yr-old patient whose 6:00 AM blood glucose is 230 mg/dL. Which action will the nurse teach the patient to take?

Check the blood glucose during the night

Which question during the assessment of a patient who has diabetes will help the nurse identify autonomic neuropathy?

"Do you feel bloated after eating?"

Which information will the nurse include in teaching a female patient who has peripheral arterial disease, type 2 diabetes, and sensory neuropathy of the feet and legs?

Choose flat-soled leather shoes.

A patient who has diabetes and reported burning foot pain at night receives a new prescription. Which information should the nurse teach the patient about amitriptyline ?

Amitriptyline helps prevent transmission of pain impulses to the brain.

A patient who has type 2 diabetes is being prepared for an elective coronary angiogram. Which information would the nurse anticipate might lead to rescheduling the test?

The patient took the prescribed metformin today.

The nurse is interviewing a new patient with diabetes who takes rosiglitazone (Avandia). Which information would the nurse anticipate resulting in the health care provider discontinuing the medication?

The patient has chest pressure when walking.

A patient with diabetic ketoacidosis is brought to the emergency department. Which prescribed action should the nurse implement first?

Infuse 1 L of normal saline per hour.

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