Sherpath Diabetes Flashcards
(19 cards)
The nurse is caring for a client with diabetes mellitus and assess symptoms of hypoglycemia. Which is the priority nursing intervention in this situation?
a. Instruct the client to take deep breaths
b. Give a glass of orange juice to the client
c. Administer insulin to the client
d. Prepare instructions for the client’s discharge teaching
b. Give a glass of orange juice to the client
Which statement by the nurse would best describe type 2 diabetes mellitus to a newly diagnosed patient?
a. “with type 2 diabetes mellitus, the body of the pancreas becomes inflamed.”
b. “With type 2 diabetes mellitus, the patient is totally dependent on an outside source of insulin.”
c. “With type 2 diabetes mellitus, insulin secretion is decreased and insulin resistance is increased.”
d. “With type 2 diabetes mellitus, the body produces autoantibodies that destroy B-cells in the pancreas.”
c. “With type 2 diabetes mellitus, insulin secretion is decreased and insulin resistance is increased.”
Type 2 Diabetes Mellitus: “Lazy Cells and a Worn-Out Pancreas”
• Cause: Insulin resistance (cells ignore insulin like a teenager ignores chores), and eventually impaired insulin secretion.
• Insulin: Initially normal or high, then declines over time as the pancreas gets tired of being ignored.
• Onset: Adulthood, often associated with obesity, inactivity, and a diet rich in sadness and carbohydrates.
• Treatment: Diet/exercise, oral meds (metformin, sulfonylureas, etc.), maybe insulin later if things go off the rails.
• Keywords: Gradual onset, insulin resistant, lifestyle factors, metabolic syndrome, still makes some insulin (for now).
Which intervention would the nurse implement initially to encourage the patient to actively participate in the management of diabetes mellitus?
a. Assess patient’s perception of what it means to have diabetes mellitus.
b. Ask the patient to write down current knowledge about diabetes mellitus.
c. Set goals for the patient to actively participate in managing diabetes mellitus.
d. Assume responsibility for all the patient’s care to decrease stress level.
a. Assess patient’s perception of what it means to have diabetes mellitus.
Which symptoms indicate that the patient is experiencing hyperglycemia?
a. Polydipsia, polyuria, and polyphagia
b. Weight gain, fatigue, and bradycardia
c. Irritability, diaphoresis, and tachycardia
d. Loss of appetite, abdominal pain, and oliguria
a. Polydipsia, polyuria, and polyphagia
The Three P’s of Hyperglycemia:
1. Polydipsia – Excessive thirst
Your blood is so sugary it turns into syrup. The kidneys freak out and try to flush out the extra glucose by making you pee a lot (foreshadowing!). This dehydrates you, and boom—you’re drinking water like it’s your job.
2. Polyuria – Frequent urination
Because your kidneys are like, “What is this glucose soup? We don’t want this in here.” So they dump it all out in the urine, and now you’re visiting the bathroom more than your own kitchen.
3. Polyphagia – Increased hunger
Even though your blood is drowning in sugar, your cells are starving because insulin isn’t working (or isn’t there). The cells are like, “Please feed us,” and your body is like, “Okay I’ll eat everything in sight,” even though the problem is really more of a delivery issue.
So yes, hyperglycemia = sweet blood, angry kidneys, confused hunger signals, and a trio of poly- symptoms that sound like a law firm:
Polydipsia, Polyuria & Polyphagia, Attorneys at Glucose
The Three P’s are like the first act of a bad play, and if you ignore them, you get DKA or HHS in Act 2. And nobody claps at the end of that show
Which time frame would the nurse instruct a patient only to drink water when scheduled for a fasting blood glucose level at 8 a.m.?
a. 6pm on the evening before the test
b. Midnight before the test
c. 4am on the day of the test
d. 7am on the day of the test
b. Midnight before the test
If a patient has a fasting blood glucose test at 8 a.m., they need to stop eating at least 8 hours before. Midnight is the nice, round cutoff healthcare professionals love because it avoids the horror of explaining math to patients at 11:47 p.m.
Here’s the cheat sheet for what “fasting” actually means:
• No food
• No coffee (yes, even black coffee — it messes with glucose)
• Only water (hydrate all you want, water is the golden child)
Which laboratory blood value would the nurse monitor in a diabetic patient treated with dexamethasone?
a. Sodium
b. Calcium
c. Potassium
d. Glucose
d. Glucose
Why? Because corticosteroids like dexamethasone are basically glucose saboteurs. They crank up gluconeogenesis in the liver, reduce peripheral glucose uptake, and basically make your insulin feel like it’s on vacation. Especially in diabetic patients, this can turn a precarious blood sugar situation into a chaotic one.
So yeah, while sodium, calcium, and potassium all deserve love (and monitoring, in other contexts), glucose is the diva that demands center stage when steroids are involved.
Which time frame would the nurse instruct the patient to take the prescribed repaglinide?
a. Immediately before meals
b. When blood sugar levels are greater than 13.9 mmol/L
c. Two hours after meals
d. At bedtime
a. Immediately before meals
Repaglinide is a rapid-acting oral hypoglycemic that tells your pancreas, “Yo, time to squeeze out some insulin because food’s about to show up.” It’s designed to lower post-meal blood sugar spikes. So if you take it and then skip the meal? Congratulations, you’ve just RSVP’d to the Hypoglycemia Express.
The key takeaway here: no food, no repaglinide. It’s basically the clingy friend who only works if you’re feeding it.
Which action would the nurse understand that the patient requires additional teaching on how to perform self-monitoring of blood glucose (SMBG)?
a. Chooses a puncture site in the center of the finger pad
b. Washes hands with soap and water to cleanse the site to be used.
c. Warms the finger before puncturing it to obtain a drop of blood.
d. Tells the nurse that the result of 110 mg/dL indicates good control of diabetes mellitus.
a. Chooses a puncture site in the center of the finger pad
The center of the finger pad is not recommended because it’s more sensitive and has more nerve endings. Ouch. Instead, blood glucose checks should be done on the sides of the finger, where it’s less painful and still gives a good blood sample
Which result reflects the expected pattern accompanying macrovascular disease as a complication of diabetes mellitus?
a. Dyslipidemia
b. Increased high-density lipoproteins (HDL)
c. Decreased low-density lipoproteins (LDL)
d. Decreased very-low-density lipoproteins (VLDL).
a. Dyslipidemia
n diabetes mellitus—particularly type 2—macrovascular complications (like coronary artery disease, peripheral artery disease, and stroke) are strongly associated with dyslipidemia, a disorder of lipid metabolism. The typical lipid pattern seen includes:
• Increased triglycerides
• Increased low-density lipoproteins (LDL) (especially small, dense LDL particles, which are more atherogenic)
• Decreased high-density lipoproteins (HDL)
So, dyslipidemia is the umbrella term that best describes this abnormal lipid profile and its contribution to macrovascular disease in diabetes
Which statement by the patient in the diabetic outpatient clinic indicates an understanding of the teaching?
a. “I will be sure to measure my finger stick blood glucose level four times a day, and more frequently when I am ill.”
b. “When I am ill, I will eliminate my Lantus insulin and only cover my finger stick blood glucose if it is over 13 mmol/L.”
c. “When I am ill, I will continue to take my Lantus insulin only.”
d. “When I am ill, I will only take my rapid acting insulin.”
a. “I will be sure to measure my finger stick blood glucose level four times a day, and more frequently when I am ill.”
Which symptom reported by a patient with type 1 diabetes mellitus is considered one of the classic clinical manifestations?
a. Excessive thirst
b. Gradual weight gain
c. Overwhelming fatigue
d. Recurrent blurred vision
a. Excessive thirst
Which statement by the patient indicates an understanding of nutritional education in a patient newly diagnosed with diabetes mellitus?
a. “When my blood sugar is less than 3.9 mmol/L, I will take 15 g of a fast-acting carbohydrate, such as orange juice, recheck in 15 minutes.”
b. “When my blood sugar is less than 3.9 mmol/L I will drink 8 oz of milk and recheck in 15 minutes.”
c. “I will eat a few hard candies when my blood sugar is less than 3.9 mmol/L and recheck in 15 minutes.”
d. “When my blood sugar is less than 3.9 mmol/L, I will take three to four sugar tablets and recheck in 30 minutes.”
a. “When my blood sugar is less than 3.9 mmol/L, I will take 15 g of a fast-acting carbohydrate, such as orange juice, recheck in 15 minutes.”
Which statement by the patient indicates that teaching about the principles of foot care has been ineffective?
a. “Taking a hot bath every day will help with my circulation.”
b. “I should avoid walking barefoot at all times.”
c. “I should look at the condition of my feet every day.”
d. “I need a podiatrist to treat my ingrown toenails.”
a. “Taking a hot bath every day will help with my circulation.”
Which information would the nurse include in the teaching about diabetes mellitus and diet?
a. Avoid nonnutritive sweeteners
b. Consume a high-protein diet for weight loss.
c. Consume food with alcohol.
d. Include 50 to 60 g/day of dietary fiber.
c. Consume food with alcohol.
When teaching patients with diabetes mellitus about alcohol, the concern is hypoglycemia, especially if they take insulin or certain oral hypoglycemics (like sulfonylureas). Alcohol inhibits gluconeogenesis in the liver, and if consumed on an empty stomach, it can increase the risk of a dangerous drop in blood sugar.
So, patients are taught to consume alcohol with food to help prevent hypoglycemia.
Which findings would the nurse expect to assess upon physical examination in a patient admitted with diabetic ketoacidosis?
a. Blood sugar 11.1 mmol/L and bradypnea
b. Hypotension and blood sugar 3.8 mmol/L
c. Diaphoresis and extreme hunger
d. Dry skin and tachycardia
d. Dry skin and tachycardia
Which is the current recommendation for fiber intake for 6 persons with diabetes mellitus?
a. 30 to 50 g/day
b. 50 to 60 g/day
c. 40 to 60 g/day
d. 10 to 20 g/day
a. 30 to 50 g/day
Which outcome best reflects good management of prediabetes in a patient completing a follow-up visit in the diabetic clinic?
a. An 8 kg weight loss
b. Hemoglobin A1C of 5.5%
c. Reduction of total cholesterol
d. Decrease in polyuria, polydipsia, and polyphagia
b. Hemoglobin A1C of 5.5%
Which explanation would the nurse provide a patient with type 2 diabetes mellitus who takes oral hypoglycemics, is admitted to the hospital with a urinary tract infection, and is prescribed insulin injections?
a. Insulin acts synergistically with the antibiotic that was prescribed.
b. Insulin should have been prescribed for the patient to take at home.
c. Oral hypoglycemic medications are contraindicated in patients with UTIs
d. The infection increases the glucose level, resulting in a need for more insulin.
d. The infection increases the glucose level, resulting in a need for more insulin.
Which information would the nurse include in the teaching plan about vascular complications associated with diabetes mellitus?
a. Macroangiopathy does not occur in type 1 diabetes mellitus but rather in type 2 diabetics who have severe disease.
b. Microangiopathy is specific to diabetes mellitus and commonly affects the capillary membranes of the eyes, kidneys, nerves, and skin.
c. Renal damage resulting from changes in large-and medium-sized blood vessels can be prevented by careful glucose control.
d. Macroangiopathy causes slowed gastric emptying and the sexual impotency experienced by a majority of patients with diabetes mellitus.
b. Microangiopathy is specific to diabetes mellitus and commonly affects the capillary membranes of the eyes, kidneys, nerves, and skin.
