Diabetes

Question 1

What is a normal fasting blood glucose range?

Answer 1

<100mg/dL

Question 2

What is a normal range for a glucose tolerance test?

Answer 2

<140mg/dL

Question 3

What is the normal range of a hemoglobin A1C test?

Answer 3

4-6%

Question 4

Symptoms of T1DM?

Answer 4

polyphagia, polydipsia, polyuria, and weight loss.

Question 5

Symptoms of T2DM?

Answer 5

polyphagia, polydipsia, polyuria, fatigue, recurrent infections, prolonged wound healing, and vision changes.

Question 6

Acute complications of T1DM?

Answer 6

DKA caused by absence of insulin and production of ketones

Question 7

Acute complications of T2DM?

Answer 7

HHS caused by insulin deficiency and profound dehydration

Question 8

What are risk factors for diabetes?

Answer 8

genetics, high BMI, limited physical inactivity, high cholesterol levels, metabolic syndrome, hx of POS and cardiovascular disease.

Question 9

What is metabolic syndrome?

Answer 9

HTN, insulin resistance, abnormal cholesterol levels, large abdominal circumference.

Question 10

What causes polyphagia in diabetes?

Answer 10

Because the glucose is all in the bloodstream the cells receive no glucose and therefore cell starvation triggers polyphagia

Question 11

Criteria for the diagnosis of pre-diabetes?

Answer 11

fasting blood glucose > 100-125mg/dL
glucose tolerance test > 140-199mg/dL
A1C 5.7-6.4

Question 12

Criteria for the diagnosis of diabetes?

Answer 12

A1C> 6.5% AND fasting blood glucose or equal to 126mg/dL.
OR
2hr blood glucose = or > 200mg/dL during oral glucose tolerance test.
OR
client showing classic manifestations of hyperglycemia or hyperglycemic crisis, a random blood glucose concentration greater than 200mg/dL

Question 13

T/F. Patients with T1DM often have weight loss and increased appetite during the weeks before diagnosis.

Answer 13

True

Question 14

Which test is generally used for the diagnosis of gestational diabetes?

Answer 14

oral glucose tolerance test

Question 15

Which tests are generally used for the diagnosis of diabetes in non pregnant adults?

Answer 15

A1C and fasting blood glucose

Question 16

Patients w/ diabetes should wash their feet daily with what?

Answer 16

Lukewarm water and soap

Question 17

Should patients with diabetes apply lotion to their feet?

Answer 17

Yes, but not between the toes

Question 18

Can patients with diabetes soak their feet?

Answer 18

No, unless specified by provider

Question 19

What sugar level is considered mild hypoglycemia?

Answer 19

<70mg/dL

Question 20

What are the sx of mild hypoglycemia?

Answer 20

hungry, irritable, shaky, nervousness

Question 21

Patient education for mild hypoglycemia?

Answer 21

consume 15g of carbs, retest blood sugar in 15 minutes, repeat tx if glucose remains <70, eat a small snack of carbs and protein if your next meal is more than 1 hour away.

Question 22

What sugar level is considered moderate hypoglycemia?

Answer 22

<40mg/dL

Question 23

What are the sx of moderate hypoglycemia?

Answer 23

cold, clammy skin, pale, rapid pulse, rapid shallow respirations, marked change in mood, drowsiness

Question 24

Patient education for treating moderate hypoglycemia?

Answer 24

consume 30g of rapidly absorbed carbs, retest glucose in 15 minutes, repeat if glucose is <60

Question 25

What glucose level is considered severe hypoglycemia?

Answer 25

<20mg/dL

Question 26

Sx of severe hypoglycemia?

Answer 26

unable to swallow, unconscious, difficulty arousing, and convulsions

Question 27

Patient education for tx of severe hypoglycemia?

Answer 27

Give prescribed dose of glucagon, give second dose in 10 minutes if patient remains unconscious, if still unconscious call 911

Question 28

Risk of hypoglycemia increases when food is delayed for how long?

Answer 28

more than 10 minutes

Question 29

Insulin storage education?

Answer 29

store in the refrigerator, keep out of sunlight and heat, have a spare supply of each type of insulin used, store pre-filled syringes in upright position, inspect vial for changes in clarity, precipitation, or color.

Question 30

What labs are checked for the management of diabetes?

Answer 30

A1C, blood glucose, urinalysis, and BUN/creatinine

Question 31

How are the Dawn phenomenon and Somogyi effect similar?

Answer 31

both associated with increased blood glucose in the morning

Question 32

What is the Dawn phenomenon?

Answer 32

when fasting blood glucose levels are high in the morning because the body does not have enough insulin

Question 33

What is the Somogyi effect?

Answer 33

Too much insulin at night causes the blood glucose to drop so the body responds by releasing hormones and glucose stores from the liver to increase blood glucose.

Question 34

When should patients check blood sugar levels to determine if they are experiencing the Dawn or Somogyi effect?

Answer 34

2-3am

Question 35

If the blood sugar is low at 2am but high in the morning the patient is experiencing what?

Answer 35

Somogyi effect

Question 36

If the blood sugar is normal or high at 2am, and high in the morning the patient is experiencing what?

Answer 36

Dawn phenomenon

Question 37

How can the Dawn phenomenon be managed?

Answer 37

providing more insulin for the overnight period (intermediate or long acting)

Question 38

How is the Somogyi effect managed?

Answer 38

adequate dietary intake at bedtime or reduce level of insulin at night

Question 39

Under what circumstances might a patient need to check blood sugar more frequently?

Answer 39

use of insulin pumps, new use of insulin or medications, acute illness/disease process, when fasting, feeling symptomatic, before and after exercise

Question 40

How many grams of carbs should be ingested for every hour of moderate intensity exercise?

Answer 40

10-15g

Question 41

Simple carbohydrates that a diabetic person can carry to treat hypoglycemia?

Answer 41

1. glucose tablets or glucose gel 2. 6-10 Life Savers or hard candy 3. 4tsp of sugar 4. 4 sugar cubes 5. 1 tbsp of honey or syrup 6. 1/2 cup of fruit juice or regular (nondiet) soft drink 7. 8oz of low fat milk 8. 6 saltine crackers 9. 3 graham crackers

Question 42

If a patient is experiencing sx of hypoglycemia but a glucose monitor is not available what is the priority nursing action?

Answer 42

assume hypoglycemia and treat accordingly

Question 43

If a patient is experiencing altered level of consciousness what is the priority tx?

Answer 43

injectable glucagon or 50% dextrose

Question 44

A patient being treated for DKA needs to be monitored closely for what possible complication?

Answer 44

cerebral edema and increased intracranial pressure

Question 45

T/F. Patients should avoid wearing shoes for 3 days in a row

Answer 45

False, for 2 days in a row

Question 46

An insulin pump administers what kind of insulin?

Answer 46

Short duration

Question 47

What is the main cause of HHS in a diabetic patient?

Answer 47

infection or severe illness

Question 48

What symptoms will most likely be seen with HHS d/t severe dehydration?

Answer 48

Mental status changes

Question 49

What is the most common side effect of Metformin that indicates lactic acidosis?

Answer 49

diarrhea

Question 50

When should patients administer insulin Lispro before a meal?

Answer 50

10 minutes before