Clinical Procedures and Protocols Flashcards

Which laboratory value is the gold standard for assessing long-term glycemic control over approximately 3 months?

Answer: Hemoglobin A1c (HbA1c)

HbA1c reflects average blood glucose over the lifespan of red blood cells (~90 days) and is the standard for long-term glycemic assessment.

A patient with type 2 diabetes is starting on a GLP-1 receptor agonist. Which side effect requires the most focused patient education at initiation?

Answer: Nausea and vomiting, especially when starting

Gastrointestinal side effects -- primarily nausea and vomiting -- are most common at GLP-1 agonist initiation and are the leading cause of discontinuation.

Which is the correct procedure for rotating insulin injection sites?

Answer: Rotate systematically within one body region before moving to another

Systematic rotation within one body region (e.g., across the abdomen) before moving to the next region prevents lipohypertrophy and maintains consistent absorption.

When interpreting a patient's CGM ambulatory glucose profile (AGP), which metric best captures glucose variability?

Answer: Coefficient of variation (CV)

Coefficient of variation (CV) is the primary metric for glucose variability; a CV of 36% or higher indicates high variability that increases hypoglycemia risk.

A patient using an insulin pump develops unexplained hyperglycemia. Which is the FIRST troubleshooting step the CDCES should recommend?

Answer: Check for kinked or occluded infusion set tubing and change the set

The first step is to inspect and change the infusion set, as kinked tubing or site occlusion is the most common cause of unexplained pump hyperglycemia.

Which blood pressure target is recommended by the ADA for most adults with diabetes and hypertension?

Answer: Less than 130/80 mmHg

The ADA recommends a blood pressure target of less than 130/80 mmHg for most adults with diabetes and hypertension to reduce cardiovascular and renal risk.