Chapter 40: Diabetes

A patient is experiencing rapid deep breathing, fruity odor, lethargy, and weight loss. Laboratory results include a blood glucose of 720 mg/dL. Which symptom should indicate to the nurse that the patient has type 1 diabetes mellitus?
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A patient is experiencing rapid deep breathing, fruity odor, lethargy, and weight loss. Laboratory results include a blood glucose of 720 mg/dL. Which symptom should indicate to the nurse that the patient has type 1 diabetes mellitus?
fruity odor
The nurse is reviewing the causes for the development of type 1 diabetes mellitus with a patient who is newly diagnosed with the disorder. What major factor in the development of this disease should the nurse include?
an autoimmune response
A patient with type 1 diabetes mellitus asks what caused the fruity odor that was present at diagnosis. How should the nurse respond?
"In the absence of available sugar, the body breaks down fat into ketones, which have a fruity odor."
A patient is newly diagnosed with type 1 diabetes mellitus. How should the nurse respond when the patient asks how long insulin injections will be necessary?
you will need insulin injections for the rest of your life
The nurse is assisting with nutrition teaching for a patient who voices concern over coping with a diabetic diet. What response about medical nutrition therapy is correct?
"You will have a well-balanced, individualized meal plan that will be healthy for your whole family."
The nurse is providing care for a marathon runner who is newly diagnosed with diabetes mellitus. What explanation about exercise is best for the nurse to provide?
"You should always take some emergency glucose with you when you are running."
The nurse is reinforcing teaching for a patient who is on four injections of regular insulin daily. About how many hours after each injection of insulin should the nurse teach the patient to be alert for symptoms of hypoglycemia?
3 hours
The nurse teaches a patient to self-administer insulin. How can the nurse best evaluate whether the patient understands the instructions?
observe as the pt prepares and injects a dose of insulin
The nurse is caring for a patient with diabetes. For which symptom should the nurse be the most concerned?
diaphoresis
The nurse is assisting with a group class on complications of diabetes. Which information should the nurse include as factors that can precipitate hyperglycemia?
stress or illness
The LPN answers the call light of a patient with diabetes. The patient has a mild tremor, slight diaphoresis, and is fully oriented. What should the nurse do?check the pt's blood glucose levelA patient asks what can be done to prevent long-term complications of diabetes. What should the nurse respond to this patients question?carefully control blood glucoseA patient is admitted to the hospital with hyperosmolar hyperglycemia. The patient is 40% overweight and has a blood glucose value of 987 mg/dL. What is the priority nursing diagnosis for this patient?Deficient fluid volume related to osmotic diuresisA patient with diabetes has peripheral neuropathy. What should the nurse do to prevent related complications?wash,dry and inspect feet dailyA standard care plan for impaired skin integrity has been implemented for a patient with a small sore on the sole of the left foot. What action should the nurse use to evaluate the effectiveness of the plan?assess and document the wound condition dailyA patient on an American Diabetes Association (ADA) exchange list diet receives a dinner meal tray and does not wish to eat the rice. Which food should the nurse substitute for the rice?slice of breadA patient being seen for diabetes at an outpatient clinic has a hemoglobin A1c level of 14%. On what conclusion should the nurse base further assessment?The patient's blood glucose levels have been elevated for the last 2 to 3 months.The nurse is caring for a patient who has not been diagnosed with diabetes. Which serum glucose result should the nurse expect on routine laboratory work?88 mg/dLA female patient is prescribed glyburide (DiaBeta) for control of blood glucose. What precaution should the nurse teach the patient about this medication?Avoid drinking alcoholThe nurse is preparing to discuss long-term complications of diabetes with a patient newly diagnosed with the disorder. Which structure should the nurse identify as causing complications because of underlying damage?Blood vesselsA patient at home with type 1 diabetes has a glucose level of 324 mg/dL. It is usually less than 150 mg/dL. What should the patient do first?check the urine for ketones and drink waterA patient whose blood glucose level ranges between 150 to 200 mg/dL has an episode of hypoglycemia. Which patient activity most likely caused the hypoglycemia?took a bicycle rideA patient being treated with rosiglitazone (Avandia) for type 2 diabetes mellitus is receiving a routine follow-up assessment. In addition to hemoglobin A1c and a fasting plasma glucose test, which other laboratory test should the nurse expect to be monitored in this patient?liver function testsA patient is diagnosed with hypoglycemia. What glucose level should the nurse expect when monitoring the capillary blood glucose?65 mg/dLThe nurse is reviewing goals for blood glucose monitoring with a patient newly diagnosed with type 2 diabetes mellitus. What pre-prandial blood glucose goal should the nurse instruct the patient to achieve?70-130 mg/dLThe nurse is caring for a patient in the critical care unit. What should the nurse identify as a goal for this patients blood glucose levels?140-180 mg/dLA patient comes into the clinic with complaints of extreme thirst, extreme urination, and ongoing hunger. Which blood glucose level should the nurse use to determine if the patient has diabetes?210 mg/dLThe nurse is preparing to administer insulin to a patient with type 1 diabetes mellitus. Which sites should the nurse consider for this injection? (Select all that apply.)Buttocks Abdomen Anterior thigh Posterior aspect of the armThe nurse is providing teaching to a patient with reactive hypoglycemia. Which instructions related to glucose monitoring should the nurse provide? (Select all that apply.)It is important to check your blood sugar at bedtime. You will need to check your blood sugar 2 hours after meals. You should check your blood sugar when you get up in the morning.A patient is diagnosed with diabetic ketoacidosis (DKA). Which manifestations should the nurse expect to observe in this patient? (Select all that apply.)Dehydration Flulike symptoms Kussmauls respirationsThe nurse is reviewing the goals and recommendations of the American Diabetes Association (ADA) prior to planning a patients care. What should the nurse keep in mind for this patient? (Select all that apply.)Aspirin therapy Yearly flu vaccine Hemoglobin A1c less than 7% Statin therapy for patients over 40 years old Peak postprandial capillary glucose less than 180 mg/dLA patient with type 1 diabetes mellitus is prescribed insulin glargine (Lantus). What should the nurse instruct the patient about this medication? (Select all that apply.)It has no peak action time. It has a duration of 24 hours. It cannot be mixed with other insulin.A patient with type 2 diabetes mellitus is prescribed metformin (Glucophage). What should the nurse assess and monitor in this patient? (Select all that apply.)Fluid retention Family history of glaucoma Presence of renal or hepatic disease Presence of congestive heart failure (CHF) Need for diagnostic tests involving use of contrast dyesThe nurse is teaching a patient about the HbA1c laboratory test. Which patient statements indicates teaching has been effective? (Select all that apply.)The test shows long-term blood sugar control. This test can be used to help diagnose diabetes. The test can be done in the physicians office while Im waiting. This test can help determine if my treatment plan is managing my diabetes effectively.The nurse is caring for a patient with type 2 diabetes mellitus. Which symptoms should the nurse recognize as indicating the patient is experiencing a Somogyi effect? (Select all that apply.)Patient reports night sweats. Fasting morning glucose is 264 mg/dL. Patient complains of headaches in the morning. Blood glucose is rising despite increased doses of insulin.After completing a health interview the nurse is concerned that a patient is at risk for developing type 2 diabetes mellitus. What information did the nurse use to make this determination? (Select all that apply.)BMI 33 Mother has type 2 diabetes mellitus Recently was downsized from employment First cousin killed in an automobile crashA patient diagnosed with prediabetes asks what can be done to prevent the development of the disease. What should the nurse recommend to this patient? (Select all that apply.)Exercise and lose weightThe nurse is reinforcing teaching on diet therapy provided to a patient with type 2 diabetes mellitus. Which patient explanations about create your plate indicate that teaching has been effective? (Select all that apply)One 8 ounce glass of low-fat milk Half the plate is non-starchy vegetablesA patient is upset to learn that a recent hemoglobin A1c level is 10.3%. What should the nurse provide as the patients average blood glucose level based upon this percentage if the equation 28.7 HbA1c 46.7 is used? (Round to the nearest whole number.)249