Diabetes Care: Glucose and Insulin Flashcards

A patient with diabetic ketoacidosis (DKA) is admitted. Which laboratory finding is most characteristic of this condition?

Answer: Blood glucose > 250 mg/dL, pH < 7.3, positive serum ketones

DKA is defined by hyperglycemia (usually >250 mg/dL), metabolic acidosis (pH <7.3), and ketonemia/ketonuria; the last option describes hyperosmolar hyperglycemic state (HHS).

When teaching a patient to perform self-monitoring of blood glucose (SMBG), which technique should the nurse emphasize?

Answer: Use the side of the fingertip rather than the pad to reduce pain and get an adequate sample

The lateral aspect of the fingertip is less sensitive and provides a good blood sample; testing while the site is still wet with alcohol can dilute the sample and give a falsely low reading.

A type 2 diabetic patient is prescribed metformin. Which assessment finding would require the LPN to hold the medication and notify the provider?

Answer: Serum creatinine of 2.4 mg/dL indicating significant renal impairment

Metformin is contraindicated with significant renal impairment (eGFR <30 mL/min) due to the risk of lactic acidosis; an elevated creatinine signals reduced renal clearance.

Which patient statement indicates a correct understanding of the Dawn phenomenon?

Answer: 'My blood sugar rises in the early morning because of hormones released during sleep, not because I ate anything.'

The Dawn phenomenon results from early-morning surges in counter-regulatory hormones (cortisol, growth hormone) that raise hepatic glucose output without prior hypoglycemia.

An LPN is caring for a patient receiving a continuous insulin infusion. The patient becomes pale, diaphoretic, and confused. Blood glucose reads 48 mg/dL. What is the immediate priority action?

Answer: Stop the insulin infusion and notify the RN immediately

Severe symptomatic hypoglycemia in a patient on an IV insulin infusion requires immediately stopping the infusion and escalating to the RN for IV dextrose administration.

A patient with type 1 diabetes develops nausea, vomiting, and inability to eat. Which sick-day rule should the nurse reinforce?

Answer: Continue taking basal insulin and check blood glucose every 2–4 hours

Illness increases counter-regulatory hormones that raise glucose; basal insulin must be continued and glucose monitored frequently even when the patient cannot eat.

Which site preparation technique is correct before subcutaneous insulin injection?

Answer: Cleanse the site with an alcohol swab and allow it to dry completely before injecting

Allowing alcohol to dry prevents a stinging sensation and ensures it does not enter the subcutaneous tissue, which could irritate or degrade the insulin.