Test Flashcards

Which one of the aforementioned chronic issues is linked to diabetes?

Answer: Retinopathy, neuropathy, and coronary artery disease

Diabetes mellitus is associated with numerous chronic complications affecting various organ systems due to prolonged hyperglycemia. Retinopathy (damage to the eyes), neuropathy (nerve damage), and coronary artery disease (heart disease) are classic examples of microvascular and macrovascular complications that significantly impact a patient's long-term health and quality of life.

The reason the nurse is aware that glucagon can be used to treat hypoglycemia is because:

Answer: Increases blood glucose levels

Glucagon is a hormone that counteracts the effects of insulin by stimulating the liver to convert stored glycogen into glucose (glycogenolysis) and to produce new glucose from non-carbohydrate sources (gluconeogenesis). This action rapidly raises blood glucose levels, making it an effective treatment for severe hypoglycemia. It essentially mobilizes the body's glucose reserves.

As part of the discharge plan, the nurse is instructing a client on how to administer insulin. Which insulin among the following begins to work the fastest?

Answer: lispro (Admelog)

Insulin lispro (Admelog) is a rapid-acting insulin analog with the fastest onset of action, typically within 15-30 minutes. This makes it ideal for administration just before or immediately after meals to effectively cover postprandial glucose excursions. Other insulins listed have slower onsets of action.

Which nursing intervention should be used for a patient who complains of nausea and throws up an hour after taking glyburide (DiaBeta)?

Answer: Monitor blood glucose closely, and look for signs of hypoglycemia

Glyburide is a sulfonylurea that stimulates insulin release, lowering blood glucose. If a patient vomits an hour after taking glyburide, the medication may have been absorbed, but the food intake that would normally counteract its effect is now absent. This significantly increases the risk of hypoglycemia, necessitating close blood glucose monitoring and assessment for low blood sugar symptoms.

A patient has infection-related diabetic ketoacidosis (DKA). Which of the following symptoms might the nurse observe when the illness worsens?

Answer: Kussmaul’s respirations and a fruity odor on the breath

As diabetic ketoacidosis (DKA) worsens, the body tries to compensate for metabolic acidosis by increasing the rate and depth of breathing, known as Kussmaul's respirations, to blow off CO2. The breakdown of fats for energy produces ketones, including acetone, which is exhaled, giving the breath a characteristic fruity odor. These are hallmark signs of severe DKA.

When it's time for bed, a client with type 1 diabetes mellitus has a fingerstick glucose level of 258 mg/dl. Insulin on a sliding scale is on order. The nurse needs to:

Answer: Administer the insulin as ordered

A fingerstick glucose level of 258 mg/dl at bedtime indicates hyperglycemia. If there is a sliding scale insulin order, the nurse should administer the prescribed amount of insulin based on this elevated blood glucose reading. This is a standard and appropriate intervention to bring blood glucose levels back into a target range and prevent further hyperglycemia overnight.

Which of the following complications is prevented while providing insulin by rotating injection sites?

Answer: Insulin lipodystrophy

Rotating insulin injection sites is crucial to prevent insulin lipodystrophy, a condition characterized by changes in fatty tissue at injection sites. Repeated injections in the same area can lead to either lipohypertrophy (lumps of fat) or lipoatrophy (indentations). These tissue changes can impair insulin absorption, making blood glucose control unpredictable and more challenging.

Which of the following electrolytes is forced into the cells by insulin from the plasma?

Answer: Potassium

Insulin plays a vital role in regulating not only glucose but also electrolyte balance. When insulin is administered, it stimulates the Na+/K+-ATPase pump, which actively transports potassium from the extracellular fluid into the cells. This cellular uptake of potassium can lead to a decrease in plasma potassium levels, making potassium the correct electrolyte.

Which of the following adjustments to a client's daily routine may be necessary for a client with type 1 diabetes when an infection is present?

Answer: More insulin

When a client with type 1 diabetes develops an infection, the body experiences physiological stress, leading to the release of counter-regulatory hormones like cortisol and glucagon. These hormones increase insulin resistance and stimulate the liver to produce more glucose, causing blood sugar levels to rise significantly. Therefore, an increased insulin dosage is typically necessary to manage the resulting hyperglycemia during illness.

Which of the following factors is the most typical cause of hyperglycaemic hyperosmolar nonketotic syndrome (HHNS)?

Answer: Undiagnosed, untreated diabetes mellitus

Hyperglycemic hyperosmolar nonketotic syndrome (HHNS) is a severe, life-threatening complication most commonly associated with type 2 diabetes. It typically occurs in individuals with undiagnosed or poorly managed diabetes, often triggered by an acute illness or infection. The body's inability to produce enough insulin or use it effectively leads to extremely high blood glucose levels and severe dehydration without significant ketone production.