Glucose Regulation

Question 1

Fasting blood glucose

Answer 1

Drawn after client has been fasting at least 8 hours

Question 2

Oral glucose test

Answer 2

Client fasts for 8-12 hours
Then given 75 g carbs orally
Blood drawn measures how body reacts to carb overload

Question 3

Random glucose test

Answer 3

Random glucose

Question 4

Hemoglobin A1c

Answer 4

Measures average of blood glucose levels over last 6-8 weeks

Question 5

Fasting Glucose level no diabetes

Answer 5

less than 100

Question 6

Fasting glucose level prediabetes

Answer 6

100-125

Question 7

Fasting glucose level diabetes

Answer 7

126 or greater

Question 8

Random glucose level diabetes

Answer 8

200 AND Signs of hyperglycemia

Question 9

A1c level no diabetes

Answer 9

Less than 5.7%

Question 10

A1c level prediabetes

Answer 10

5.7-6.4%

Question 11

A1c level diabetes

Answer 11

6.5% or above

Question 12

If the client has been diagnosed with diabetes. What should the nurse education about their A1c?

Answer 12

Target range is 7.0% for a client diagnosed with diabetes

Question 13

My Plate method:

Answer 13

50% - non-starchy veggies (green leafy things)
25% - Starches (grains, pasta, or starchy veggies)
25% - low fat lean meats

Question 14

Pt. BS is 90 an the client is getting ready to go for a jog. What should the nurse educate the client?

Answer 14

Eat a snack if your BS is on the low side to prevent hypoglycemia while exercising

Question 15

The pt. is sick for a week and BS has dropped to 50. What education point should the nurse touch on?

Answer 15

You should take your long acting insulin even when you are sick.

Question 16

True/False: It is okay for a diabetic pt to powder feet with cornstarch if they are sweaty.

Answer 16

True

Question 17

True/False: It is okay for the diabetic pt. to wear plastic shoes like Crocs for protection

Answer 17

False: plastic shoes hold in more moisture

Question 18

The pt. states that she will get sugar free fruit juice in order to stay hydrated on days she is sick. Nurse response:

Answer 18

You should get regular fluids such as gatorade, fruit juice that are high in carbs to replace electrolytes and keep BS norm

Question 19

The nurse hears diabetic client who is sick at home say she has not eaten a full meal in the past 3 days. What should the nurse do?

Answer 19

Notify the provider immediately and tell pt. to seek Tx at ER

Question 20

Diabetic seek Tx if ER if:

Answer 20

Decreased LOC
Sick > 2 days
Temp > 102 for > 12hrs
Temp doesn't respond to meds
Increased RR
Can't tolerate fluids
BS > 240 consistently

Question 21

Biguanides Ex.

Answer 21

Metformin

Question 22

Precautions for Metformin

Answer 22

Can cause Renal impairment

**Do not give IV contrast within 48 hours of taking Metformin

Question 23

Sulfonylureas Ex.

Answer 23

Glyburide (Glynase)

Question 24

Glyburide precaution

Answer 24

Can cause hypoglycemia

Question 25

Thiazolidinediones Ex.

Answer 25

Pioglitazone (Actos)

Question 26

Pioglitazone precautions

Answer 26

Can cause Heart failure and liver toxicity

Question 27

IV insulin is given in ____

Answer 27

IV insulin is given in Emergencies

Question 28

Ex of rapid acting insulin

Answer 28

Humalog/Lispro

Question 29

Ex. long acting insulin

Answer 29

Lantus Glargine Levemir/Detemir

Question 30

Ex. of short acting insulin

Answer 30

Regular/Novolin

Question 31

What is premixed insulin?

Answer 31

Mixed long and short acting insulins

Question 32

True/False: Premixed insulins do not have to be given with food

Answer 32

False, they have long and short acting insulin. | Short acting must be given with meals

Question 33

Premixed insulins must be given ___ ___

Answer 33

Premixed insulins must be given WITH FOOD

Question 34

Causes of Hyperglycemia

Answer 34

``` Not producing enough or any insulin (Type 1) Insulin resistance (Type 2) ```

Question 35

Causes of Hypoglycemia

Answer 35

``` Too much insulin Sickness Sulfonylureas Alcohol Beta-blockers (mask symptoms) ```

Question 36

Dawn Phenomenon

Answer 36

Body naturally release a burst of hormones at 5-8 am that increase BS. Pt. may have increase fasting BS in morning

Question 37

Somogyi Effect

Answer 37

Pt. take insulin before bed with have decreased BS then glucagon is released 2-3 am and result in higher than normal BS in morning Tx: decrease insulin dose at night

Question 38

Hypoglycemia

Answer 38

BS < 70

Question 39

Hypoglycemia can cause ____

Answer 39

Seizures

Question 40

Priority safety when the nurse is caring for a client with BS of 55

Answer 40

Seizure precautions

Question 41

Tx for hypoglycemia

Answer 41

``` 15-15 rule Eat 15 grams of carbs Wait 15 min. Recheck BS Repeat until norm ```

Question 42

If pt. is unconscious and their BS is 25 what can the nurse do?

Answer 42

Give Glucagon or IV D50W

Question 43

Glucagon

Answer 43

IM - most common | IV or SQ

Question 44

D50W

Answer 44

Assess IV site before and after admin for extravasation

Question 45

DKA is a complication of which type of diabetes?

Answer 45

Type 1

Question 46

DKA produces ___

Answer 46

Ketones

Question 47

DKA BS usually gets above

Answer 47

DKA BS >250

Question 48

DKA will cause what electrolyte imbalance

Answer 48

Hyperkalemia

Question 49

DKA usually results in what acid/base imbalance

Answer 49

Metabolic acidosis

Question 50

What is the first action on Tx of DKA

Answer 50

Tx dehydration FIRST

Question 51

What is the priority action on Tx of DKA

Answer 51

Kill the sugar and get rid of ketones Bs > 250 IV insulin BS < 200 SQ insulin and D5W

Question 52

When treating a pt. with DKA the nurse administers IV insulin. What is her concerns with admining IV insulin

Answer 52

Hypoglycemia - switch to D5W when BS <200 | Hypokalemia - Tx with K+ supplement

Question 53

HHS is a complication of what type of diabetes?

Answer 53

Type 2

Question 54

A pt. with HHS the nurse should expect to see BS over what?

Answer 54

> 600

Question 55

In HHS there is ___ insulin

Answer 55

In HHS that is SOME insulin

Question 56

In DKA there is __ insulin

Answer 56

In DKA there is NO insulin

Question 57

In HHS because of the high glucose levels in the blood the nurse knows the fluid in the body is flowing ___ the blood vessels

Answer 57

Fluid is flowing INTO the blood vessels - dehydrating the tissues

Question 58

Priority concerns and assessment for pt. in HHS

Answer 58

Mental status, seizures

Question 59

First action Tx fo HHS

Answer 59

Treat the dehydration FIRST

Question 60

Priority intervention for pt with HHS

Answer 60

Stabilize BS (SQ or IV)

Question 61

Causes of HHS

Answer 61

Illness | Infection

Question 62

Causes of DKA

Answer 62

Sepsis Sickness Stress/Surgery Skipping insulin

Question 63

What kind of acid/base imbalance is a pt. with HHS most likely to be in?

Answer 63

Alkalosis

Question 64

What kind of respiration will a pt. with DKA exhibit?

Answer 64

Kussmauls

Question 65

True/False: HHS develops ketones

Answer 65

False, no ketones are present in HHS. Ketones are present in DKA