Diabetes Test 5
A nurse is creating a plan of care for a client with hyperglycemia and diabetes mellitus. The following would be the top nursing diagnosis:
Explanation:
The kidneys will eliminate the glucose in the urine as a result of elevated blood glucose. Along with the fluids and electrolytes, this glucose induces osmotic diuresis, which results in dehydration. When the fluid loss gets significant, it needs to be replaced.
The blood gases of a patient show diabetic acidosis. The nurse should prepare for:
Explanation:
The body fluids' pH is maintained via the bicarbonate-carbonic acid buffer system, which is decreased in metabolic acidosis due to an increase in metabolic acids. The overproduction of?-hydroxybutyric acid and acetoacetic acid causes acidosis in DKA. These two keto acids entirely separate at physiological pH, and the extra hydrogen ions bind the bicarbonate, causing the serum bicarbonate levels to drop.
When first admitted for treatment of hyperglycemia, a client with DM exhibits severe anxiety. The following would be the most effective intervention to lessen the client's anxiety:
Explanation:
The best course of action is to talk to the client about their anxiety-related feelings. Create and preserve a trusting connection through being available, showing warmth, asking straightforward questions, giving unconditional acceptance, and respecting the client's usage of personal space.
A client with type 2 diabetes mellitus receives a physical evaluation from a nurse. Fasting blood glucose levels were 120 mg/dl, temperature was 101 °F, pulse rate was 88 bpm, respirations were 22 bpm, and blood pressure was 140/84 mmHg. Which finding would worry the nurse the most?
Explanation:
An infection may be indicated by an increased temperature. The most common cause of diabetic ketoacidosis or hyperglycemic hyperosmolar nonketotic syndrome is infection. The patient may be febrile or hypothermic due to the potential for an infectious trigger for DKA. The patient may experience other infectious symptoms like fever, cough, or other urinary symptoms if a superimposed infection caused the episode of DKA.
The insulin that would be given to a patient who has diabetic ketoacidosis is:
Explanation:
Short-acting regular insulin (Humulin R) is given intravenously in doses of 0.3 units/kg initially, 0.2 units/kg an hour later, and 0.2 units/kg every two hours until blood glucose levels reach 13.9 mmol/L (250 mg/dL). Until the DKA resolves, the insulin dosage should now be cut in half, to 0.1 units/kg every 2 hours.
When exercising, a client with type 1 diabetes phones the nurse frequently to report episodes of hypoglycemia. Which client comment revealed a lack of knowledge regarding the peak action of NPH insulin with exercise?
Explanation:
Increased exercise may trigger a hypoglycemic reaction. Exercise should be avoided by clients during the peak insulin period. Exercise in the afternoon will take place during the medication's peak time because NPH insulin peaks between 6 and 14 hours later.
An ER patient with DKA is being cared for by a nurse. The most important nursing action during the acute period is to get ready to:
Explanation:
The main factor causing DK1 is insulin deficiency (either absolute or relative). The standard of therapy is continuous intravenous insulin infusion. A more recent prospective randomized trial showed that individuals receiving hourly insulin infusions at 0.14 U/kg/hr do not require a bolus.
A cell needs glucose because it is largely used for the following functions:
Explanation:
The primary mechanism for cellular energy production is glucose catabolism. Every organism in the universe uses it as a constant source of energy, and it is necessary to power both anaerobic and aerobic cellular respiration. When glucose enters the body, it moves through the blood to the tissues that need it for energy.
A patient with hypoglycemia is being admitted by the nurse. Describe the symptoms and indicators the nurse should look out for. Please check all that apply.
Please select 3 correct answers
Explanation:
Although signs and symptoms may not appear until plasma glucose concentrations fall below 55 mg/dL, hypoglycemia is frequently defined as a plasma glucose concentration below 70 mg/dL. Neurogenic or neuroglycopenic symptoms of hypoglycemia can be identified clinically.
A patient with diabetes mellitus goes to a clinic for medical attention. Glyburide (Diabeta), 5 mg PO daily, has previously been effective in controlling the client's diabetes, but more lately, the fasting blood glucose has been ranging between 180 and 200 mg/dl. What drug, if it had been added to the client's regimen, might have caused the hyperglycemia?
Explanation:
The effects of insulin, diuretics, oral hypoglycemics, and potassium supplements may all be diminished by prednisone. Prednisone may hinder the ability of metFORMIN and other diabetes drugs to manage blood sugar levels. Keep an eye on your blood sugar levels. During and after prednisone treatment, the client may require a dose adjustment of the diabetic drugs.